| NPI | 1548545866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ENRIQUETA CARMONA President 323-569-3333 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: CA 60024) |
| Additional Taxonomies | 332B00000X Durable Medical Equipment & Medical Supplies |
| Enumeration Date | 2011-10-18 |
| Last Update Date | 2020-11-25 |