| NPI | 1003125808 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONNA MCCANDLESS Office Manager 818-905-9586 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A4198) |
| Enumeration Date | 2010-09-28 |
| Last Update Date | 2024-04-18 |