| NPI | 1225099526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRAKOB VASSANTAHCART Direct Owner 818-888-7815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G61725) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G61725) |
| Enumeration Date | 2006-03-28 |
| Last Update Date | 2009-05-12 |