| NPI | 1013478130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE SARIAN Practice Administrator 818-348-7246 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0000X |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2019-03-29 |