| NPI | 1154577195 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN D. CAMICO Owner 310-540-9699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| 207Q00000X Family Medicine | |
| Enumeration Date | 2008-08-11 |
| Last Update Date | 2008-08-11 |