| NPI | 1265142038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL BRAZELL Chief Operating Officer 310-339-6824 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207RS0010X Internal Medicine, Sports Medicine |
| 225100000X Physical Therapist | |
| 207T00000X Neurological Surgery | |
| Enumeration Date | 2022-12-01 |
| Last Update Date | 2026-01-09 |