| NPI | 1902936099 |
|---|---|
| Former Legal Business Name | PARKLANE MEDICAL GROUP INC |
| Entity Type | Organization |
| Authorized Contact | GEORGE CHIKELUE IFEORAH Director 310-677-5090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Enumeration Date | 2007-03-07 |
| Last Update Date | 2013-03-20 |