| NPI | 1619307451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SPARKY GREENE CEO 310-344-5558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QC1800X Clinic/Center, Corporate Health | |
| 261QH0100X Clinic/Center, Health Services | |
| Enumeration Date | 2013-11-14 |
| Last Update Date | 2013-11-14 |