| NPI | 1124654132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KESSINGTON ENAYE OKUNDAYE Managing Partner 818-571-8708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261Q00000X Clinic/Center | |
| 261QE0002X Clinic/Center, Emergency Care | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QU0200X Clinic/Center, Urgent Care | |
| Enumeration Date | 2020-03-21 |
| Last Update Date | 2024-10-04 |