| NPI | 1780988915 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YAROSLAV S GOFNUNG CEO 818-893-5819 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A81752) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A81752) |
| 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: A81752) | |
| Enumeration Date | 2011-01-03 |
| Last Update Date | 2011-01-03 |