| NPI | 1790767200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM T. ROSS Executive Director 562-424-8001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 2061585) |
| Enumeration Date | 2005-11-18 |
| Last Update Date | 2020-08-22 |