NPI | 1265674485 |
---|---|
Doing Business As | SPORTS MEDICINE & PREVENTIVE MEDICAL GROUP |
Entity Type | Organization |
Authorized Contact | KARLIS CONRAD ULLIS Medical Director 310-452-1990 |
Organization Subpart ? | No |
Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA G20989) |
Additional Taxonomies | 2083S0010X Preventive Medicine, Sports Medicine (Licence: CA G20989) |
Enumeration Date | 2009-04-02 |
Last Update Date | 2014-03-07 |