| NPI | 1871329615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID LOUIS MATLOCK Medical Director 310-859-9052 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology |
| Additional Taxonomies | 208200000X Plastic Surgery |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |