| NPI | 1386846491 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HOWARD RAYMOND JACKSON Physician Owner 213-481-7026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| 171100000X Acupuncturist | |
| 207Q00000X Family Medicine | |
| 208100000X Physical Medicine & Rehabilitation | |
| 208D00000X General Practice | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine | |
| Enumeration Date | 2007-06-01 |
| Last Update Date | 2007-10-04 |