| NPI | 1659625796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL MATTHEW CHAVIRA Medical Director 310-923-9931 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA A89310) |
| Enumeration Date | 2012-10-26 |
| Last Update Date | 2013-01-08 |