| NPI | 1962008003 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BAKER CFO 818-395-3060 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207QG0300X Family Medicine, Geriatric Medicine |
| 363LP2300X Nurse Practitioner, Primary Care | |
| Enumeration Date | 2020-12-04 |
| Last Update Date | 2020-12-04 |