NPI | 1497781579 |
---|---|
Entity Type | Organization |
Authorized Contact | AMOS CHEERKEY ACOFF President 213-413-4203 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA FNP 24915) |
Enumeration Date | 2006-06-23 |
Last Update Date | 2020-08-22 |