| NPI | 1619435427 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARCHIE MAYS Administrator 818-762-8702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2019-03-11 |
| Last Update Date | 2019-03-11 |