| NPI | 1265831606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OKSANA KOMOVA Manager 818-274-2447 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical (Licence: CA A42285) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |