| NPI | 1295138758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VINCENT JOSEPH DONATO Owner 310-621-4951 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA G62334) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA CA19760) |
| 111NN1001X Chiropractor, Nutrition (Licence: CA CA19760) | |
| Enumeration Date | 2014-09-29 |
| Last Update Date | 2014-09-29 |