| NPI | 1588071245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FERNANDO RODRIGUEZ Pr Ogram Director 818-902-1100 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA 190803AP) |
| Enumeration Date | 2014-07-15 |
| Last Update Date | 2014-07-17 |