| NPI | 1598067167 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNE S CENICEROS Billing & Collections Mgr 562-594-6599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization |
| Enumeration Date | 2010-12-02 |
| Last Update Date | 2010-12-06 |