| NPI | 1487875191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICE LEE Administrator 626-965-1988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 208000000X Pediatrics |
| Enumeration Date | 2007-05-01 |
| Last Update Date | 2022-07-21 |