| NPI | 1962912741 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES WALTER LONG CEO 818-661-6367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2018-10-03 |