| NPI | 1912417007 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID JACINTO HERNANDEZ Director 818-403-8728 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0505X Family Medicine, Adult Medicine (Licence: CA G48343) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2024-11-27 |