| NPI | 1316412729 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY I BAUTISTA President & CEO 818-462-4899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 208D00000X General Practice | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| 213E00000X Podiatrist | |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2018-10-11 |