| NPI | 1770774366 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REZA RAY EHSAN Medical Director 310-390-9551 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 261QM2500X Clinic/Center Medical Specialty (Licence: CA A50372) |
| 261QE0002X Clinic/Center Emergency Care (Licence: CA A50372) | |
| 261QM1300X Clinic/Center Multi-Specialty (Licence: CA A50372) | |
| 261QP3300X Clinic/Center Pain (Licence: CA A50372) | |
| 261QU0200X Clinic/Center Urgent Care (Licence: CA A50312) | |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2010-02-22 |