| NPI | 1750439154 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BROWNELL HILLIARD PAYNE Medical Director 310-560-9292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center Ambulatory Surgical |
| Enumeration Date | 2007-01-08 |
| Last Update Date | 2022-03-06 |