| NPI | 1508030107 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LESLIE FOGELSON Owner 310-828-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology Psychiatry (Licence: CA G39149) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2008-04-15 |