| NPI | 1073574000 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILLIP JORGE Direct Owner 818-888-7815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G78921) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G78921) |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2009-09-22 |