| NPI | 1134389489 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE L MACDOUGALL Owner 310-545-2900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G55441) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2009-07-22 |