| NPI | 1063615581 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PENNY L MAKABENTA Physician Assistant 562-988-7370 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA 18214) |
| Enumeration Date | 2007-06-11 |
| Last Update Date | 2020-08-22 |