| NPI | 1255999215 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IAN DWORKIN Director 949-491-9991 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation Pain Medicine |
| Enumeration Date | 2019-06-04 |
| Last Update Date | 2020-03-17 |