| NPI | 1376865964 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANTHONY FENISON Medical Director 909-888-2210 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA G73330) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2011-03-01 |