NPI | 1184044240 |
---|---|
Entity Type | Organization |
Authorized Contact | VIVIENNE LEE CEO 323-583-4660 |
Organization Subpart ? | No |
Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 47111) |
Enumeration Date | 2014-04-16 |
Last Update Date | 2014-04-16 |