NPI | 1326278490 |
---|---|
Doing Business As | KIDS & TEENS MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | JANESRI WIJAYANGANI DE SILVA President 818-361-5437 |
Organization Subpart ? | No |
Primary Taxonomy | 208000000X Pediatrics (Licence: CA A88991) |
Additional Taxonomies | 2080A0000X Pediatrics, Adolescent Medicine (Licence: CA A88991) |
Enumeration Date | 2009-07-22 |
Last Update Date | 2020-06-15 |