| NPI | 1952430324 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMAD T SHOKRAEI President 818-881-0671 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302F00000X Exclusive Provider Organization (Licence: CA A53012B) |
| Enumeration Date | 2007-03-03 |
| Last Update Date | 2008-06-19 |