| NPI | 1376907535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIC SICKINGER Owner 760-636-1067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204C00000X Neuromusculoskeletal Medicine, Sports Medicine (Licence: CA 20A13043) |
| Enumeration Date | 2016-04-13 |
| Last Update Date | 2020-03-25 |