| NPI | 1710500483 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HASMIK JASMINE AVETISYAN Credentialing And Billing Manager 818-294-7997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-07-03 |