| NPI | 1982216214 |
|---|---|
| Doing Business As | CONCIERGE IV NUTRITION |
| Entity Type | Organization |
| Authorized Contact | DAVID KHOSROW HAKIMIAN Clerk 424-335-0260 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Enumeration Date | 2020-08-18 |
| Last Update Date | 2020-08-18 |