| NPI | 1710659800 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA PITTS Owner 323-807-3615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2021-09-28 |
| Last Update Date | 2022-01-27 |