| NPI | 1669569018 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELENA JASSO Billing Manager 310-444-8808 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 930000863) |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2020-08-22 |