| NPI | 1043951742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CORBIN MICHAEL ALLRED Owner / Physician Assistant 818-903-9006 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2022-04-05 |
| Last Update Date | 2022-04-05 |