| NPI | 1770072803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAYANA FIGUEROA Credentialing Manager 310-448-2693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2018-05-03 |