| NPI | 1417051533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT EDMUND WYCOFF Administrator 626-577-3415 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 930000938) |
| Enumeration Date | 2006-09-11 |
| Last Update Date | 2008-08-28 |