| NPI | 1427482173 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS C CLOUD Chairman Credentialing Committe 323-301-2178 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2013-08-29 |
| Last Update Date | 2022-07-21 |