| NPI | 1487024519 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GANI ALVERO MAGHIRAN VP 818-486-8093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 44029) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2015-10-01 |