NPI | 1871738971 |
---|---|
Entity Type | Organization |
Authorized Contact | LEROY W VAUGHN President/Owner 310-671-0909 |
Organization Subpart ? | No |
Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A30576) |
Enumeration Date | 2008-12-04 |
Last Update Date | 2008-12-04 |