| 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 | 2025-01-23 |