| NPI | 1972166452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNY BRAGANZA Credentialing Manager 562-341-4786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Y00000X Otolaryngology |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2019-04-19 |
| Last Update Date | 2019-04-19 |