| NPI | 1265657191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA M HERRARTE Medical Biller 310-794-4130 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA 32213027) |
| Enumeration Date | 2007-04-16 |
| Last Update Date | 2009-05-05 |