| NPI | 1467993824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN KELLEHER Owner 310-721-0744 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA A107765) |
| Enumeration Date | 2017-03-17 |
| Last Update Date | 2017-03-17 |