| NPI | 1881082683 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICARDP ANTONIO TAN Owner 310-709-2693 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0201X Internal Medicine, Allergy & Immunology (Licence: CA A52236) |
| Enumeration Date | 2014-12-31 |
| Last Update Date | 2014-12-31 |