| NPI | 1114253671 |
|---|---|
| Doing Business As | KIDS & TEENS MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | JANESRI WIJAYANGANI DE SILVA President 818-782-7600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208000000X Pediatrics (Licence: CA A88991) |
| Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA A88991) |
| Enumeration Date | 2009-10-19 |
| Last Update Date | 2009-10-19 |