| NPI | 1245304328 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK WAX President Sole Owner 818-888-7815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA A28870) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA A28870) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2020-08-22 |