| NPI | 1760914782 |
|---|---|
| Doing Business As | CAL STATE LOS ANGELES |
| Entity Type | Organization |
| Authorized Contact | MOUZON BASS Agent 972-367-4845 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA 18176) |
| Enumeration Date | 2017-03-29 |
| Last Update Date | 2017-03-29 |