| NPI | 1457703134 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ILYA VLADIMIR YEPISHIN President 310-408-2891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine, Geriatric Medicine (Licence: HI DOS-1673) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2016-07-06 |