| NPI | 1487519740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DESIRAE SOLTERO-FARIAS Administrative Staff 310-867-1767 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 261QP2000X Clinic/Center, Physical Therapy |
| Enumeration Date | 2025-12-18 |
| Last Update Date | 2025-12-29 |