| NPI | 1588997449 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL A. WOOLF Owner 323-974-6159 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: AZ 4228) |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services (Licence: AZ 2080) |
| Enumeration Date | 2009-09-10 |
| Last Update Date | 2009-09-10 |