| 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 |