| NPI | 1235131277 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLENE GOFF Administrator 818-442-9080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 930000966) |
| Enumeration Date | 2005-08-10 |
| Last Update Date | 2020-08-22 |