| NPI | 1104084623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAMBI L. NICKELBERRY Physician 310-673-3737 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G46679) |
| Enumeration Date | 2008-05-30 |
| Last Update Date | 2008-06-02 |