| NPI | 1679988844 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNA D GUANCHE Doctor 818-225-0117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: CA 51713) |
| Enumeration Date | 2014-06-26 |
| Last Update Date | 2014-06-26 |