| NPI | 1164679718 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID VESCO Owner 818-880-0799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 43384A) |
| Enumeration Date | 2008-08-26 |
| Last Update Date | 2014-11-14 |