| NPI | 1003217902 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KASRA ROWSHAN Medical Director 949-732-0303 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 111NR0400X Chiropractor, Rehabilitation |
| 1223G0001X Dentist, General Practice | |
| 207R00000X Internal Medicine | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |