| NPI | 1497503130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KHADEER KHAN Director 310-387-2054 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 363LF0000X Nurse Practitioner, Family | |
| Enumeration Date | 2024-05-08 |
| Last Update Date | 2024-11-27 |