| NPI | 1801190699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LIZA MARIE VISMANOS CEO 310-341-3134 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA G20777) |
| Enumeration Date | 2011-01-07 |
| Last Update Date | 2011-01-07 |