| NPI | 1962145029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERARDO CANCHOLA Medical Director 714-353-5333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208D00000X General Practice |
| 261Q00000X Clinic/Center | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2022-04-18 |
| Last Update Date | 2023-04-16 |