| NPI | 1063601888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ADRIANA VEDA SHEPHERD Office Manager 818-790-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G30953) |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2020-09-02 |