NPI | 1154894616 |
---|---|
Doing Business As | KETAMINE CLINICS OF LOS ANGELES |
Entity Type | Organization |
Authorized Contact | SAMUEL HERBERT MANDEL Chief Operating Officer 310-270-0625 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2019-01-08 |
Last Update Date | 2019-01-08 |