| NPI | 1679347298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN BASS Member, Gove RN Ing Body 818-285-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |