| NPI | 1467991745 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES SIMBULAN President 818-224-9390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NV NV20171090051) |
| Enumeration Date | 2017-02-20 |
| Last Update Date | 2017-02-20 |