| NPI | 1194049635 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLILP WAYNE LEWIS Owner 818-346-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: CA DC22395) |
| Enumeration Date | 2010-03-25 |
| Last Update Date | 2010-03-25 |