| NPI | 1093249633 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALDO SAN JOSE Owner 323-333-4366 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA 15761) |
| Enumeration Date | 2017-04-19 |
| Last Update Date | 2017-04-19 |