| NPI | 1457595159 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE L CHRISTIE Owner 310-259-7719 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 12746) |
| Enumeration Date | 2009-04-24 |
| Last Update Date | 2009-04-24 |