| NPI | 1205385390 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH T MALLAS Enrollment Specilist 661-678-2600 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine |
| Enumeration Date | 2016-09-29 |
| Last Update Date | 2016-09-29 |