| NPI | 1003968942 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROMERO Clinic Administrator 310-732-7500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1100X Clinic/Center, MilitaryU.S. Coast Guard Outpatient |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |