| NPI | 1104958784 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIANSI BONI Owner 310-644-3488 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A45536) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A45536) |
| 208000000X Pediatrics (Licence: CA A45536) | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A45536) | |
| Enumeration Date | 2007-03-10 |
| Last Update Date | 2025-09-11 |