| NPI | 1346917465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANIEL PHILIP LODER President 310-792-3914 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine Pain Medicine |
| Additional Taxonomies | 207L00000X Anesthesiology |
| 207LP2900X Anesthesiology Pain Medicine | |
| 332B00000X Durable Medical Equipment & Medical Supplies | |
| Enumeration Date | 2021-08-26 |
| Last Update Date | 2021-08-26 |