| NPI | 1093305260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN SHULTZ Employee 310-896-5183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 207RA0401X Internal Medicine, Addiction Medicine |
| Enumeration Date | 2021-01-21 |
| Last Update Date | 2021-01-21 |