| 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 |