| NPI | 1710735741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SELENE KEPILA CEO 310-965-6821 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2024-05-06 |
| Last Update Date | 2024-05-06 |