| NPI | 1316259179 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARYL P BANTA Doctor 626-486-0181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RC0200X Internal Medicine Critical Care Medicine |
| Additional Taxonomies | 207RP1001X Internal Medicine Pulmonary Disease |
| Enumeration Date | 2010-07-09 |
| Last Update Date | 2011-08-09 |