| NPI | 1689079402 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUIS SAMANIEGO Family Medicine Program Director 323-260-5789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 284300000X Special Hospital (Licence: CA 20A13554) |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 20A13554) |
| 261QU0200X Clinic/Center, Urgent Care (Licence: CA 20A13554) | |
| Enumeration Date | 2014-10-23 |
| Last Update Date | 2014-10-23 |