| NPI | 1215940606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRENDA M KLASS Administrator 818-784-0990 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA G36778A) |
| Additional Taxonomies | 103TC0700X Psychologist, Clinical (Licence: CA PSY14180) |
| 106H00000X Marriage & Family Therapist (Licence: CA MFC21561) | |
| 111NX0800X Chiropractor, Orthopedic (Licence: CA 23728) | |
| 171100000X Acupuncturist (Licence: CA AC4054) | |
| 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA G36778) | |
| 207RA0401X Internal Medicine, Addiction Medicine (Licence: CA C26209) | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A41871) | |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: CA Functional Restorati) | |
| 261QP2000X Clinic/Center, Physical Therapy (Licence: CA PT22297) | |
| 261QR0400X Clinic/Center, Rehabilitation | |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2025-09-11 |