| NPI | 1679642847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHEAL M OMIDI Owner Operator 310-273-8885 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A84519) |
| Enumeration Date | 2006-11-06 |
| Last Update Date | 2020-08-22 |