| NPI | 1174884258 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUDHIR RAO Owner 310-703-8767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 174400000X Specialist |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YP2500X Counselor Professional | |
| 103TA0400X Psychologist Addiction (Substance Use Disorder) | |
| 103TC0700X Psychologist Clinical | |
| 207LP2900X Anesthesiology Pain Medicine | |
| 208VP0000X Pain Medicine Pain Medicine | |
| 208VP0014X Pain Medicine Interventional Pain Medicine | |
| 363LP0808X Nurse Practitioner Psychiatric/Mental Health | |
| Enumeration Date | 2012-06-05 |
| Last Update Date | 2025-06-27 |