| NPI | 1215030747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WALTER JAYASINGHE Owner 213-483-2620 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A31911) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A49332) |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA A26210) | |
| 208000000X Pediatrics (Licence: CA A38978) | |
| 363A00000X Physician Assistant (Licence: CA PA14480) | |
| 363A00000X Physician Assistant (Licence: CA PA14957) | |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2020-08-22 |