| NPI | 1205196094 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES A HARTLEROAD Owner 818-988-9825 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: CA 00G749010) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 00G749010) |
| Enumeration Date | 2012-05-25 |
| Last Update Date | 2012-05-25 |