| NPI | 1558853234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ABRAHAM EBBIE SOROUDI Medical Director 310-474-2010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-05-30 |
| Last Update Date | 2020-04-27 |