NPI | 1134317472 |
---|---|
Entity Type | Organization |
Authorized Contact | ANTIONETTE EPPS Administrator 310-668-5201 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA PHE14221) |
Enumeration Date | 2007-10-11 |
Last Update Date | 2007-10-11 |