| NPI | 1942829346 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VAUGHN DANAO Administrator 818-299-3110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center, Multi-Specialty |
| Enumeration Date | 2020-04-15 |
| Last Update Date | 2020-08-25 |