| NPI | 1871743278 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN AYRIYAN Executive Director 818-551-0026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA 20A5179) |
| Enumeration Date | 2008-09-23 |
| Last Update Date | 2008-09-23 |