| NPI | 1861777062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARA JULIETTE BOYADJIAN Manager 818-888-2700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 37449) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |