| NPI | 1457666885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENT MOELLEKEN Medical Director/Owner 310-273-1001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2010-08-10 |
| Last Update Date | 2010-11-04 |