| NPI | 1164200739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARIEL GAVINO Medical Director 818-860-4330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine |
| Additional Taxonomies | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2023-09-15 |
| Last Update Date | 2025-06-27 |