| NPI | 1174807424 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RASOUL POOYANDEH CEO 909-620-8500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA A106704) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 27512) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A106704) | |
| Enumeration Date | 2011-10-05 |
| Last Update Date | 2014-07-25 |