| NPI | 1922448836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VIKRAM KOTHANDARAMAN Medical Director 323-266-4446 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: CA A91809) |
| Enumeration Date | 2013-06-25 |
| Last Update Date | 2013-06-28 |