| NPI | 1174929376 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW S ROOT Authorized Official 818-621-0019 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2014-11-15 |
| Last Update Date | 2019-09-29 |