| NPI | 1831519156 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLEN C. FARKAS Medical Director 818-518-5980 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA G56249) |
| Enumeration Date | 2014-04-25 |
| Last Update Date | 2015-10-05 |