| NPI | 1497943252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EUGENE FUKUMOTO Manager 626-299-4900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G5507) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA11460) |
| 363A00000X Physician Assistant (Licence: CA PA16862) | |
| 363A00000X Physician Assistant (Licence: CA PA16393) | |
| 363A00000X Physician Assistant (Licence: CA PA11867) | |
| 363A00000X Physician Assistant (Licence: CA PA15767) | |
| Enumeration Date | 2007-10-05 |
| Last Update Date | 2007-10-05 |