| NPI | 1619372380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT LAI Medical Director 818-736-5836 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2017-01-30 |