| NPI | 1033430319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARICA SUE LEE Department Administrator 323-857-4142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 17657) |
| Enumeration Date | 2010-06-21 |
| Last Update Date | 2010-06-21 |