| NPI | 1104465541 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL SUNGWON KIM CEO 818-939-4511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2020-01-02 |
| Last Update Date | 2020-11-05 |