| NPI | 1023524980 |
|---|---|
| Former Legal Business Name | NONE |
| Entity Type | Organization |
| Authorized Contact | MIKE MANSOUR ROSTAMI Medical Director/ Owner 323-957-9300 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A50108) |
| Enumeration Date | 2017-12-14 |
| Last Update Date | 2017-12-20 |