| NPI | 1366467904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LEATA MOORE Billing Manager 760-243-0464 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0117X Orthopaedic Surgery, Orthopaedic Surgery of the Spine |
| Additional Taxonomies | 2251X0800X Physical Therapist, Orthopedic |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2014-02-20 |