| NPI | 1205371341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERIK BRIAN Owner 949-370-0771 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0401X Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF) (Licence: CA 300182DP) |
| Enumeration Date | 2016-12-28 |
| Last Update Date | 2016-12-28 |