| NPI | 1063282390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GABRIEL DIOP Authorized Agent 323-205-7088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084A0401X Psychiatry & Neurology Addiction Medicine |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-09-12 |