| NPI | 1427237650 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARRY MATTHEW COGEN Director 805-644-3311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A5574) |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation Sports Medicine (Licence: CA 20A5574) |
| Enumeration Date | 2007-10-24 |
| Last Update Date | 2007-10-24 |