| NPI | 1184587115 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HAYNES Sr. Director, Compliance 818-434-1977 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2025-12-05 |
| Last Update Date | 2025-12-05 |