| NPI | 1174702377 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY IAN GROSSER President 818-929-2259 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: CA A67128) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2022-09-04 |