| NPI | 1891134268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NDIKA FOMUKONG CEO 310-701-6703 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 34954) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 34954) |
| 207R00000X Internal Medicine (Licence: CA 34954) | |
| 207V00000X Obstetrics & Gynecology (Licence: CA 34954) | |
| 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: CA 34954) | |
| Enumeration Date | 2013-06-19 |
| Last Update Date | 2016-01-13 |