| NPI | 1912156217 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAUL HENRY GIBONEY Physician 323-987-1401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: CA A067450) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2008-09-11 |