| NPI | 1215404132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FADY ELIAS Md 909-372-0000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2018-10-29 |
| Last Update Date | 2018-10-29 |