| NPI | 1124452875 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD BERTON MANTELL Owner 626-359-8604 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA A39992) |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2013-08-29 |