| NPI | 1821893983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN EARL BRISTOL Nurse Practicioner 310-795-7528 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2025-02-13 |
| Last Update Date | 2025-02-13 |