| NPI | 1760503569 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY NAVA Accounting Manager 310-203-8899 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: CA 960000179) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2014-06-25 |