| NPI | 1750442836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND MENCHACA Medical Director 323-588-1383 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA G75144) |
| Enumeration Date | 2006-12-13 |
| Last Update Date | 2018-03-09 |