| NPI | 1598118911 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARRELL NELMS Executive Director 323-777-2491 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA 190288BN) |
| Enumeration Date | 2016-07-20 |
| Last Update Date | 2016-07-20 |