| NPI | 1093452278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY J KIM Owner 818-913-2393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2023-08-01 |