| NPI | 1376538132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRASERT BASIL VASSANTACHART Owner 626-282-3113 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA GH4008) |
| Enumeration Date | 2005-09-16 |
| Last Update Date | 2011-09-01 |