| NPI | 1134487895 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AZMINA KANJI Adminastrator 1818-264-3997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 05-4550) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2012-05-01 |