| NPI | 1134736705 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADWIN GILL CEO 818-262-5900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM2500X Clinic/Center, Medical Specialty | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2021-12-10 |