| NPI | 1154765899 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROCHELLE R SKINNER President 323-933-5641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 54813) |
| Enumeration Date | 2013-04-24 |
| Last Update Date | 2013-10-25 |