| NPI | 1043325731 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRENCE J FITZGIBBONS Medical Director 213-481-0584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA G32025) |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2020-08-22 |