| NPI | 1659744951 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD PAUL FRIEDER Owner 310-998-1949 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QG0250X (Licence: CA G45278) |
| Additional Taxonomies | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G45278) |
| Enumeration Date | 2015-11-09 |
| Last Update Date | 2015-11-09 |