| NPI | 1144855461 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON SABOL Provider 661-834-1544 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| Enumeration Date | 2020-03-06 |
| Last Update Date | 2020-03-06 |