| NPI | 1104398601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HAMED TAHERI Authorized Official, President 562-435-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0129X Surgery, Vascular Surgery |
| Additional Taxonomies | 208600000X Surgery |
| Enumeration Date | 2018-12-20 |
| Last Update Date | 2018-12-20 |