| NPI | 1811456478 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA JUNG Clinical Director 310-378-0547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0600X |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical |
| 103TH0004X Psychologist, Health | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| Enumeration Date | 2019-03-13 |
| Last Update Date | 2021-08-31 |