| NPI | 1346591575 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE MOORE Owner 619-321-0093 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207LP2900X Anesthesiology, Pain Medicine |
| Additional Taxonomies | 111N00000X Chiropractor |
| 2081P0004X Physical Medicine & Rehabilitation, Spinal Cord Injury Medicine | |
| 208VP0000X | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2012-09-27 |
| Last Update Date | 2012-09-27 |