| NPI | 1073665071 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD SAMPSON President 323-728-7998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 930000640) |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |