| NPI | 1992179618 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY PERAINO Member 818-481-6310 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 207Q00000X Family Medicine |
| 207QG0300X Family Medicine Geriatric Medicine | |
| 207X00000X Orthopaedic Surgery | |
| 213ES0103X Podiatrist Foot & Ankle Surgery | |
| 363A00000X Physician Assistant | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2015-11-18 |
| Last Update Date | 2015-11-18 |