| NPI | 1528345915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRY ROSTAMI Administrator 626-337-0676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A7473) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA20545) |
| Enumeration Date | 2011-11-14 |
| Last Update Date | 2012-03-14 |