| NPI | 1588530976 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE L BOONE Authorized Official 310-919-9560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2025-10-14 |
| Last Update Date | 2025-10-14 |