| NPI | 1407077217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY BENAVIDES Medical Assistant 310-360-0280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA 20A3999) |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2009-04-08 |