NPI | 1215102215 |
---|---|
Entity Type | Organization |
Authorized Contact | TAVONIA SIDONEY RUSSELL Director 310-462-6082 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA FNP 38172) |
Enumeration Date | 2008-04-30 |
Last Update Date | 2009-02-19 |