| NPI | 1356874127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADLEY THOMAS Owner 310-546-3461 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A72166) |
| Enumeration Date | 2017-04-07 |
| Last Update Date | 2017-04-07 |