| 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 | 2014-06-18 |