| NPI | 1851605992 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VERONICA MORALES BANTA Chief Executive Officer/President 323-461-0777 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: CA A104447) |
| Enumeration Date | 2010-07-30 |
| Last Update Date | 2010-08-12 |