| NPI | 1134838352 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN FAVINI Principal 323-704-5716 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 172V00000X Community Health Worker |
| Enumeration Date | 2022-11-16 |
| Last Update Date | 2025-04-10 |