| NPI | 1518375252 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA C. BARBARINO Medical Director 310-402-2255 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A107345) |
| Enumeration Date | 2014-07-25 |
| Last Update Date | 2014-07-25 |