| NPI | 1962542159 |
|---|---|
| Former Legal Business Name | LAGUNA VIEJO PEDIATRIC MEDICAL GROUP, INC. |
| Entity Type | Organization |
| Authorized Contact | DENNIS S PHILLIPS President 949-951-1376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA G320830) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2020-08-22 |