| NPI | 1093003741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KERITH KELLY Credentialing Manager 626-204-6747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A41269) |
| Enumeration Date | 2011-07-15 |
| Last Update Date | 2011-07-15 |