| NPI | 1265540256 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIGALAT SHALITA Owner 818-676-0080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 20A9000) |
| Enumeration Date | 2006-08-29 |
| Last Update Date | 2023-03-07 |