| NPI | 1205017514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA POLL GOODMAN Owner/P.T. 310-441-1102 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA 18437) |
| Additional Taxonomies | 174400000X Specialist (Licence: CA PT 18437) |
| Enumeration Date | 2007-11-15 |
| Last Update Date | 2016-09-14 |