| NPI | 1942353693 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ROMERO Clinic Administrator 310-732-7519 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1101X Clinic/Center, Military and U.S. Coast Guard Ambulatory Procedure |
| Enumeration Date | 2007-01-18 |
| Last Update Date | 2020-08-22 |