| NPI | 1407869928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONRADO J.R MIRANDA Medical Director 818-701-0017 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A48817) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2007-11-12 |