| NPI | 1144668336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKSHMI MAKAM Medical Director 323-846-4104 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service (Licence: CA A30975) |
| Additional Taxonomies | 261QP2300X Clinic/Center Primary Care (Licence: CA A30975) |
| Enumeration Date | 2013-06-10 |
| Last Update Date | 2013-06-10 |