| NPI | 1336330745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMIE JACOBSON Billing Manager 818-774-1771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G39082) |
| Enumeration Date | 2007-08-09 |
| Last Update Date | 2012-11-20 |