NPI | 1760868418 |
---|---|
Doing Business As | WEST GARDENA COMMUNITY CLINIC |
Entity Type | Organization |
Authorized Contact | ALICE BLACI President 310-436-7760 |
Organization Subpart ? | No |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20AA5193) |
Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA12545) |
Enumeration Date | 2015-08-05 |
Last Update Date | 2015-08-05 |