| NPI | 1588805717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ONSTON PLACIDE Director 310-868-5379 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 10503162001) |
| Enumeration Date | 2009-03-18 |
| Last Update Date | 2009-03-18 |