| NPI | 1194102004 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIM DO Authorized Official 714-283-3242 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT29580) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2015-04-29 |