NPI | 1316027279 |
---|---|
Entity Type | Organization |
Authorized Contact | SORAYA ANNE ROSS Owner 310-888-1234 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA G51213) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
Enumeration Date | 2006-10-16 |
Last Update Date | 2024-03-26 |