| NPI | 1760906507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL WOSK Secretary 562-463-0172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA 56374) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 71133) |
| 207Q00000X Family Medicine (Licence: CA 45086) | |
| Enumeration Date | 2017-08-02 |
| Last Update Date | 2017-10-26 |