| NPI | 1013275965 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SEAN S RAVAEI Owner 310-673-0523 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 00014995) |
| Enumeration Date | 2012-04-30 |
| Last Update Date | 2013-07-08 |