| NPI | 1619041050 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAYNE S GRADMAN Medical Director 310-550-9200 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 930001006) |
| Enumeration Date | 2006-11-18 |
| Last Update Date | 2020-08-22 |