| NPI | 1043560295 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL P TAHERI Owner 310-993-8994 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: NV 20120078160-37) |
| Enumeration Date | 2012-09-14 |
| Last Update Date | 2020-08-07 |