| NPI | 1437592417 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN LICHTWARDT Director 310-741-7799 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center Health Service |
| Additional Taxonomies | 246RP1900X Technician, Pathology Phlebotomy (Licence: CA CPT54625) |
| Enumeration Date | 2013-04-09 |
| Last Update Date | 2013-04-23 |