| NPI | 1043493570 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI WICKMAN Biller 626-857-7400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A43746) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A020970) |
| Enumeration Date | 2007-12-06 |
| Last Update Date | 2011-01-12 |