| NPI | 1629864335 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JONATHAN BURKET Cco 818-666-0602 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology |
| 261QP3300X Clinic/Center, Pain | |
| Enumeration Date | 2025-04-18 |
| Last Update Date | 2025-04-18 |