| NPI | 1316455165 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD R KHOSRAVI CEO 747-477-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 6656) |
| Enumeration Date | 2018-01-15 |
| Last Update Date | 2018-01-15 |