| NPI | 1376985564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY GEORGE Assistant Director Of Clinic 562-650-0639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 1103278) |
| Enumeration Date | 2013-07-29 |
| Last Update Date | 2013-07-29 |