| NPI | 1013255280 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDRICK RUSSO President 818-837-5785 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207V00000X Obstetrics & Gynecology |
| Additional Taxonomies | 208600000X Surgery |
| 208800000X Urology | |
| Enumeration Date | 2013-01-23 |
| Last Update Date | 2013-01-23 |