| NPI | 1962013870 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILIP RYAN MOLARTE CAMILON CEO 714-900-1117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 207YP0228X Otolaryngology, Pediatric Otolaryngology |
| Enumeration Date | 2020-08-13 |
| Last Update Date | 2020-08-17 |