| NPI | 1184025025 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SAMUEL RYAN PARK CEO 949-207-7650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A75650) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: CA A75650) |
| Enumeration Date | 2014-09-10 |
| Last Update Date | 2014-09-10 |