| NPI | 1588341689 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH HEINZERLING Director 310-393-7129 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine, Addiction Medicine |
| Additional Taxonomies | 106H00000X Marriage & Family Therapist |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |