| NPI | 1053992784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALLEN SCOTT MILLER Manager 626-399-6834 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain |
| Additional Taxonomies | 261QI0500X Clinic/Center, Infusion Therapy |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-04-15 |