| NPI | 1174916779 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THERESA CANGIALOSI Pediatric Nurse Practitioner 310-697-6833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: CA 9281) |
| Enumeration Date | 2015-03-06 |
| Last Update Date | 2015-03-06 |