| NPI | 1699396754 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NANOTCHKA CHUNLEY Owner 310-598-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2020-04-29 |
| Last Update Date | 2020-04-29 |