| NPI | 1770122566 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR CHANG Director 310-993-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X Community/Behavioral Health | |
| 261QE0700X Clinic/Center, End-Stage Renal Disease (ESRD) Treatment | |
| 261QH0100X Clinic/Center, Health Services | |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QP2000X Clinic/Center, Physical Therapy | |
| 261QP2300X Clinic/Center, Primary Care | |
| 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) | |
| 261QR1100X Clinic/Center, Research | |
| 261QS1200X Clinic/Center, Sleep Disorder Diagnostic | |
| 261QU0200X Clinic/Center, Urgent Care | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| 335V00000X Portable X-Ray and/or Other Portable Diagnostic Imaging Supplier | |
| Enumeration Date | 2019-12-27 |
| Last Update Date | 2020-03-19 |