| NPI | 1326503590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND BENJAMIN RAVEN Authorized Official 818-841-3936 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery |
| 207XS0114X Orthopaedic Surgery, Adult Reconstructive Orthopaedic Surgery | |
| 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine | |
| 207XX0004X Orthopaedic Surgery, Foot and Ankle Surgery | |
| 207XX0005X Orthopaedic Surgery, Sports Medicine | |
| Enumeration Date | 2019-02-01 |
| Last Update Date | 2019-02-01 |