NPI | 1164776340 |
---|---|
Entity Type | Organization |
Authorized Contact | ALLEN KAMRAVA President 424-279-8222 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A103694) |
Enumeration Date | 2012-11-09 |
Last Update Date | 2024-11-15 |