| NPI | 1215757059 |
|---|---|
| Former Legal Business Name | INNOVA MEDICAL NETWORK INC |
| Entity Type | Organization |
| Authorized Contact | JOON PARK Chief Operation Officer 702-761-9915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2024-10-16 |
| Last Update Date | 2024-10-16 |