| NPI | 1376266833 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLADELYNN ADLAO Vice President 626-705-1005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry |
| 261Q00000X | |
| Enumeration Date | 2022-09-20 |
| Last Update Date | 2022-09-20 |