| NPI | 1992181143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGA SIMONIAN CEO 818-570-1636 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: CA PSY25302) |
| Enumeration Date | 2015-08-10 |
| Last Update Date | 2019-11-19 |