| NPI | 1194175117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY ANDREW VIRELLA Medical Director 818-889-1858 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2016-06-21 |
| Last Update Date | 2016-06-21 |