| NPI | 1104016856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERWINN C SISTOZA President 310-348-9138 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: CA A76101) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A76101) |
| Enumeration Date | 2007-07-30 |
| Last Update Date | 2008-01-14 |