| NPI | 1669211207 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND S DOUGLAS President 310-657-4302 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM1300X Clinic/Center Multi-Specialty |
| Additional Taxonomies | 261QI0500X Clinic/Center Infusion Therapy |
| Enumeration Date | 2024-05-22 |
| Last Update Date | 2024-05-22 |