| NPI | 1548455496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PETER B. FODOR Owner 310-203-9818 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA C29169) |
| Enumeration Date | 2007-09-12 |
| Last Update Date | 2007-12-06 |