| NPI | 1033267216 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LORNA JOHNSON Administrator 323-588-0084 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A33986) |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA NMW1068) |
| 261QP2300X Clinic/Center, Primary Care (Licence: CA A88137) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: CA PA16806) | |
| 261QP2300X Clinic/Center, Primary Care (Licence: CA G42217) | |
| Enumeration Date | 2007-01-06 |
| Last Update Date | 2020-08-22 |