| NPI | 1922487560 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOYCE VAN BRUCK Owner 818-400-6396 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RN0300X Internal Medicine Nephrology |
| Additional Taxonomies | 207Q00000X Family Medicine |
| Enumeration Date | 2015-05-28 |
| Last Update Date | 2015-06-16 |