| NPI | 1326452822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA MARTINEZ Credentialing 818-340-0265 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine (Licence: FL ME87839) |
| Enumeration Date | 2014-06-12 |
| Last Update Date | 2014-06-12 |