| NPI | 1912240193 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATHAN DANIEL FORD President 818-884-8607 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A122580) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A122580) |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2013-04-05 |