| NPI | 1104452283 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN DERRINGTON Physician/Presdient 760-721-4000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine |
| Enumeration Date | 2020-03-20 |
| Last Update Date | 2020-04-28 |