| NPI | 1679096150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH ENAYATI Medical Director 310-651-6937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 13199) |
| Enumeration Date | 2017-07-17 |
| Last Update Date | 2017-07-17 |