NPI | 1780277012 |
---|---|
Entity Type | Organization |
Authorized Contact | GLENN VALLECILLOS CEO/Medical Director 310-273-3007 |
Organization Subpart ? | No |
Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical |
Enumeration Date | 2021-02-17 |
Last Update Date | 2022-01-17 |