NPI | 1992114730 |
---|---|
Entity Type | Organization |
Authorized Contact | JOHN MICHAEL WAITE President 310-968-3123 |
Organization Subpart ? | No |
Primary Taxonomy | 363A00000X Physician Assistant (Licence: CA 56135) |
Enumeration Date | 2014-08-06 |
Last Update Date | 2014-08-06 |