| NPI | 1225556673 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN PETERS Office Adminsitrator 310-456-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics (Licence: CA A24797) |
| Enumeration Date | 2017-09-06 |
| Last Update Date | 2022-07-21 |