| NPI | 1851619365 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CINDY ANNE SUMMERS Owner 818-985-4413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA DC27667) |
| Enumeration Date | 2010-05-07 |
| Last Update Date | 2010-05-07 |