| NPI | 1003570805 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI RAY Director Of Operations 310-890-9544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332B00000X Durable Medical Equipment & Medical Supplies |
| Additional Taxonomies | 261QD0000X Clinic/Center Dental |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2022-03-16 |