| NPI | 1255369260 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA VAZQUEZ Medical Claims Processor 213-617-2947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 24988) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2008-07-07 |