| NPI | 1649992777 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TATYANA CHARNY COO 818-304-1628 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery |
| Additional Taxonomies | 208D00000X General Practice |
| Enumeration Date | 2022-09-15 |
| Last Update Date | 2022-09-15 |