| NPI | 1982992442 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BETH A MOORE Physician 310-854-3580 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: CA G83667) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA G83667) |
| Enumeration Date | 2011-07-19 |
| Last Update Date | 2011-09-23 |