| NPI | 1992724959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBYLUZ KEENEY Credentialing Coordinator 714-965-2543 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2024-10-01 |