| NPI | 1962695122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYAM GADDAM Medical Director 1714-636-9100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: pending) |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2014-09-25 |