| NPI | 1710152590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD ELLENBOGEN Practice Owner 310-276-3183 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 1787947) |
| Enumeration Date | 2008-04-23 |
| Last Update Date | 2008-04-23 |