| NPI | 1740755149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENYS SLESARENKO Chief Financial Officer 310-204-6897 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2018-10-11 |
| Last Update Date | 2020-08-11 |