| NPI | 1114193182 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NISSAN KAHEN Medical Director 323-725-0167 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A410610) |
| Enumeration Date | 2008-04-30 |
| Last Update Date | 2008-04-30 |