| NPI | 1306462742 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DOBLE Administrator 310-408-8714 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2020-06-22 |
| Last Update Date | 2020-06-22 |