| NPI | 1154846111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEREK TAN DEE President 310-882-3884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A65423) |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2017-08-17 |