| NPI | 1811339856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUIS T. BASCOY Owner/President 323-269-0411 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center Medical Specialty (Licence: CA A29037) |
| Enumeration Date | 2013-07-18 |
| Last Update Date | 2013-07-18 |