| NPI | 1144862517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN E BOHM CEO 949-551-0868 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology Pain Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| 261QP3300X Clinic/Center Pain | |
| Enumeration Date | 2019-10-17 |
| Last Update Date | 2019-10-24 |