| NPI | 1730564501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FIDEL CUPINO Secretary 562-881-1615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: CA DDS 41910) |
| Enumeration Date | 2015-07-22 |
| Last Update Date | 2015-07-22 |