| NPI | 1649457037 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GUSTAVO T. ROLDAN Manager 323-566-9171 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: CA 0711339) |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2013-01-10 |