| NPI | 1225304843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | URI M BEN-ZUR President/Owner 818-986-7460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA G75051) |
| Additional Taxonomies | 302F00000X Exclusive Provider Organization (Licence: CA G75051) |
| 305S00000X Point of Service (Licence: CA G75051) | |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2012-03-28 |