| NPI | 1104154244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARA SALAZAR Administrator 310-273-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2009-12-01 |
| Last Update Date | 2009-12-10 |