| NPI | 1588056014 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN FORTICH Revenue Cycle Management Director 626-893-9730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QG0300X Family Medicine Geriatric Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2021-05-25 |