| NPI | 1467225821 |
|---|---|
| Doing Business As | PROSPECT LATINO MEDICAL GROUP, INC. |
| Entity Type | Organization |
| Authorized Contact | ROBERT ELDERS Secretary 310-943-4500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |