| NPI | 1649381807 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKTI SRIVASTAVA Owner 661-332-3355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2018-05-20 |