| NPI | 1043404486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAROLD ALAN LUBICK Doctor/President 818-848-5591 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA 28035) |
| Enumeration Date | 2007-08-29 |
| Last Update Date | 2007-08-29 |