| NPI | 1205301397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LACEY ZACK President 213-338-1521 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2018-10-04 |
| Last Update Date | 2020-01-06 |