| NPI | 1477994341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN LAZARO BANZUELA President 310-320-9905 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: CA PT24628) |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2013-07-08 |