| NPI | 1669551941 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH KIANFU LEE Owner/President 818-344-4210 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 930000888) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2025-01-20 |