| NPI | 1477088540 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN H NOVACK President 310-888-8818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 19917) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2017-04-26 |