| NPI | 1194319905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPHINE M WHITE Administrative Assistant 916-953-7571 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2021-02-22 |