| NPI | 1679019202 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUZANNA NEGUSSIE Medical Director/ Owner 310-200-8045 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2017-01-06 |