| NPI | 1083485437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA BROUSSARD Owner 213-205-5376 |
| Organization Subpart ? | No |
| Primary Taxonomy | 246Y00000X Spec/Tech, Health Info |
| Additional Taxonomies | 246Z00000X Specialist/Technologist, Other |
| 251B00000X Case Management | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 302R00000X Health Maintenance Organization | |
| 3336S0011X Pharmacy, Specialty Pharmacy | |
| Enumeration Date | 2024-01-15 |
| Last Update Date | 2024-01-15 |