NPI | 1548824063 |
---|---|
Entity Type | Organization |
Authorized Contact | JENNY BRAGANZA Credentialing Manager 323-341-4786 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center |
Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
Enumeration Date | 2019-04-30 |
Last Update Date | 2019-04-30 |