| NPI | 1932300944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER CONNELLY Owner 562-988-0040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RE0101X Internal Medicine Endocrinology, Diabetes & Metabolism (Licence: CA W17025) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: CA W17025) |
| Enumeration Date | 2007-05-29 |
| Last Update Date | 2018-01-22 |