| NPI | 1750628715 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUNILA NANDINI FUSTER Presidnet 310-543-3109 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A36239) |
| Enumeration Date | 2013-01-11 |
| Last Update Date | 2013-01-11 |