| NPI | 1255362687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FREDERICK J LI Front Office Supervisor 818-888-2855 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G065065) |
| Additional Taxonomies | 363A00000X Physician Assistant (Licence: CA PA 16970) |
| 225100000X Physical Therapist (Licence: CA PT24912) | |
| 207X00000X Orthopaedic Surgery (Licence: CA A79561) | |
| 213ES0103X Podiatrist, Foot & Ankle Surgery (Licence: CA E3859) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2023-05-11 |