| NPI | 1710331400 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK SAMONTE Medical Director 310-850-5630 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: CA 95004061) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2025-09-07 |