| NPI | 1982152815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN RICHARDSON CEO 323-546-9631 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 363AM0700X Physician Assistant Medical |
| Enumeration Date | 2016-09-20 |
| Last Update Date | 2016-09-20 |