| NPI | 1396954921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACKIE CHAN President 209-529-4422 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2500X Clinic/Center, Medical Specialty (Licence: CA G077865) |
| Additional Taxonomies | 261QP3300X Clinic/Center, Pain (Licence: CA G077865) |
| Enumeration Date | 2007-05-21 |
| Last Update Date | 2023-08-24 |