| NPI | 1396376745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL TRUONG CEO 310-912-2305 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208VP0000X |
| Enumeration Date | 2020-02-03 |
| Last Update Date | 2020-02-03 |