| NPI | 1447003314 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JEFFREY HALERIN Chief Operating Officer 213-309-9528 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical | 
| Additional Taxonomies | 213ES0103X Podiatrist, Foot & Ankle Surgery | 
| Enumeration Date | 2024-04-09 | 
| Last Update Date | 2024-08-26 |