| NPI | 1609391382 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GEOFFREY JIMENEZ Owner 310-276-7388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 213EP1101X Podiatrist, Primary Podiatric Medicine | |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2023-01-16 |