| NPI | 1982954640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL P TAHERI Owner 310-922-1412 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA1903X Clinic/Center, Ambulatory Surgical (Licence: CA 3453870) |
| Enumeration Date | 2012-09-10 |
| Last Update Date | 2020-08-11 |