| NPI | 1013372242 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONDA CHASE Owner 310-375-7599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA 95003531) |
| Enumeration Date | 2015-12-14 |
| Last Update Date | 2015-12-14 |