| NPI | 1164633053 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE ELDERBAUM Billing Manager 661-213-4157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC24224) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA A65257) |
| Enumeration Date | 2007-05-24 |
| Last Update Date | 2020-08-22 |