| NPI | 1699796813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERITE DANIAL Book Keeper 818-501-5326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA A30870) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-03-03 |