| NPI | 1306220538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL WHITE Office Manager 310-670-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 23007) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 393487) |
| Enumeration Date | 2015-07-17 |
| Last Update Date | 2015-07-17 |