| NPI | 1376186940 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SICKINGER Physician/Owner 760-636-1067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine |
| Enumeration Date | 2019-10-25 |
| Last Update Date | 2020-04-07 |