| NPI | 1336845148 |
|---|---|
| Doing Business As | FUNCTIONAL RESTORATION SAN DIEGO |
| Entity Type | Organization |
| Authorized Contact | JOEL E MATA Owner/ Practitioner 858-837-4477 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Enumeration Date | 2023-02-02 |
| Last Update Date | 2023-02-02 |