| NPI | 1770041881 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD MATLOCK COO 310-887-1730 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Additional Taxonomies | 207YX0007X Otolaryngology, Plastic Surgery within the Head & Neck |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2021-09-20 |