| NPI | 1902846306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY CHURCH CFO 323-442-8747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: NA) |
| Additional Taxonomies | 208600000X Surgery (Licence: NA) |
| 207L00000X Anesthesiology (Licence: NA) | |
| 207N00000X Dermatology (Licence: NA) | |
| 207Q00000X Family Medicine (Licence: NA) | |
| 207R00000X Internal Medicine (Licence: NA) | |
| 207T00000X Neurological Surgery (Licence: NA) | |
| 207V00000X Obstetrics & Gynecology (Licence: NA) | |
| 207W00000X Ophthalmology (Licence: NA) | |
| 207X00000X Orthopaedic Surgery (Licence: NA) | |
| 207Y00000X Otolaryngology (Licence: NA) | |
| 207ZP0102X Pathology, Anatomic Pathology & Clinical Pathology (Licence: NA) | |
| 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: NA) | |
| 2085R0202X Radiology, Diagnostic Radiology | |
| 208800000X Urology (Licence: NA) | |
| Enumeration Date | 2006-06-07 |
| Last Update Date | 2023-02-27 |