| NPI | 1063779304 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLEN LARITA SCHMIDT OLAIVAR CEO And CFO 310-962-0035 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 21119) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 6287) |
| 261Q00000X Clinic/Center (Licence: CA 6509) | |
| Enumeration Date | 2012-04-11 |
| Last Update Date | 2014-10-21 |