| NPI | 1942766621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH KILLEBREW COO 714-655-3625 |
| Organization Subpart ? | No |
| Primary Taxonomy | 390200000X Student in an Organized Health Care Education/Training Program |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |