| NPI | 1063458503 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAN DINH NGUYEN Owner 323-588-2186 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A39092) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA A64451) |
| Enumeration Date | 2006-06-22 |
| Last Update Date | 2010-01-19 |