| NPI | 1265776744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEROMY DEAN RATZLAFF Secretary 949-855-1887 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 207R00000X Internal Medicine | |
| 225100000X Physical Therapist | |
| Enumeration Date | 2012-11-21 |
| Last Update Date | 2012-11-21 |