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 |