| NPI | 1306722830 |
|---|---|
| Other Name | JONATHAN GERVASI |
| Entity Type | Organization |
| Authorized Contact | JONATHAN GERVASI Marketing Director 626-390-4080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QV0200X Clinic/Center, VA |
| Enumeration Date | 2025-08-12 |
| Last Update Date | 2025-08-12 |