| NPI | 1932641420 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NEIL GHODADRA Medical Director 310-801-6741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA A116163) |
| Enumeration Date | 2016-11-15 |
| Last Update Date | 2019-10-01 |