| NPI | 1952451049 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON MARK GALBRAITH Owner 949-360-6009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine |
| Enumeration Date | 2007-01-11 |
| Last Update Date | 2022-11-30 |