| NPI | 1245374354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX YACOUB Billing Office Manager 323-720-9204 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208800000X Urology (Licence: CA A40189) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A40189) |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2020-02-14 |