| NPI | 1982032603 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD DAVID BUCKBERG President 310-206-1027 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: CA G11527) |
| Enumeration Date | 2013-10-15 |
| Last Update Date | 2013-10-15 |