| NPI | 1063646727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK TANG Clinic Director 626-297-2340 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NX0800X Chiropractor Orthopedic (Licence: CA 27175) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: CA 27175) |
| 111NS0005X Chiropractor Sports Physician (Licence: CA 27175) | |
| Enumeration Date | 2009-05-11 |
| Last Update Date | 2009-05-11 |