| NPI | 1104955665 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN T PACK Owner 310-820-9123 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: CA C34674) |
| Enumeration Date | 2007-03-02 |
| Last Update Date | 2008-07-07 |