| NPI | 1679945695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY SCHOSER Revenue Cycle Manager 323-364-6489 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: CA 66975) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) (Licence: CA 35886) |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine (Licence: CA 136475) | |
| Enumeration Date | 2015-10-29 |
| Last Update Date | 2022-01-18 |