| NPI | 1386952562 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELITA N MOORE CEO 916-492-2110 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA A108599) |
| Enumeration Date | 2010-09-21 |
| Last Update Date | 2010-09-21 |