| NPI | 1841477767 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | BERTHA A GONZALEZ President 323-728-1274 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA 20A6849) |
| Enumeration Date | 2008-01-22 |
| Last Update Date | 2008-01-22 |