| NPI | 1669886388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LETANTIA BUSSELL Medical Director 310-550-7661 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2014-06-20 |
| Last Update Date | 2014-06-20 |