| NPI | 1720229487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDO MIRANDA President 310-914-1624 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA 5165) |
| Enumeration Date | 2009-03-10 |
| Last Update Date | 2009-03-12 |