| NPI | 1841298775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARIA I. SELIVERSTOV CEO 818-986-9232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0805X Psychiatry & Neurology, Geriatric Psychiatry (Licence: CA A066938) |
| Additional Taxonomies | 2084P2900X Psychiatry & Neurology, Pain Medicine (Licence: CA A066938) |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2007-11-06 |