| NPI | 1528438876 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAHMINA SULTANA HAQ O5167616wner 310-487-7468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA a116126) |
| 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA a116126) | |
| 261QE0800X Clinic/Center, Endoscopy (Licence: CA a116126) | |
| 282E00000X (Licence: CA a116126) | |
| 282N00000X General Acute Care Hospital (Licence: CA a116126) | |
| Enumeration Date | 2015-09-29 |
| Last Update Date | 2015-09-29 |