NPI | 1205576345 |
---|---|
Entity Type | Organization |
Authorized Contact | KELLY MARTIN Owner 626-223-5071 |
Organization Subpart ? | No |
Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine |
Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry |
Enumeration Date | 2022-03-29 |
Last Update Date | 2022-03-29 |