| NPI | 1275015414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEXANDER SOROKURS Medical Director 310-622-5369 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-09-04 |
| Last Update Date | 2018-09-04 |