| NPI | 1285776237 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL RIDJAN Director 818-509-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA 0002055859-0001-1) |
| Enumeration Date | 2007-02-13 |
| Last Update Date | 2020-08-22 |