| NPI | 1174362818 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SOM KOHANZADEH President 310-429-2257 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery |
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-07-22 |