| NPI | 1669074928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHIRLEE JACKSON Chief Operations Office 310-507-7946 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PE0005X Emergency Medicine, Undersea and Hyperbaric Medicine |
| Additional Taxonomies | 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine |
| Enumeration Date | 2020-11-12 |
| Last Update Date | 2020-11-12 |