| NPI | 1306411426 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIREEN BRIONES Client Service Manager 310-967-1971 |
| Organization Subpart ? | No |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site |
| Additional Taxonomies | 174400000X Specialist |
| Enumeration Date | 2021-05-21 |
| Last Update Date | 2021-07-13 |