| NPI | 1245317411 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVAN RICHARD JACOBS Precident 310-652-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA C27493) |
| Enumeration Date | 2006-11-01 |
| Last Update Date | 2008-09-25 |