| NPI | 1225564909 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONSTANTINO MENDIETA Owner 310-529-9237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: FL 41181) |
| Enumeration Date | 2017-05-02 |
| Last Update Date | 2017-05-02 |