| NPI | 1316110885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA BERBERYAN Counselor 818-551-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 197331) |
| Enumeration Date | 2008-04-07 |
| Last Update Date | 2008-04-07 |