| NPI | 1164614699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK MARDEN TAN Director 310-826-3180 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0804X Psychiatry & Neurology, Child & Adolescent Psychiatry (Licence: CA G31393) |
| Additional Taxonomies | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry (Licence: CA G31393) |
| Enumeration Date | 2007-08-17 |
| Last Update Date | 2007-08-17 |