| NPI | 1386513281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIUS ANDRE GAYANILO MORAN Secretary 818-912-0330 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Enumeration Date | 2025-10-30 |
| Last Update Date | 2025-10-30 |