| NPI | 1114473972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINALD C AJAKWE Medical Director 818-325-2088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2016-08-31 |
| Last Update Date | 2016-12-26 |