| NPI | 1982409579 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FARAH BANGASH Owner 310-955-8213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 363L00000X Nurse Practitioner |
| Enumeration Date | 2025-02-17 |
| Last Update Date | 2025-02-17 |