| NPI | 1881288702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE DAVIS CEO 323-219-8124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care |
| Additional Taxonomies | 225100000X Physical Therapist |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |