| NPI | 1508139957 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATTHEW J. ENNA Owner 310-858-3880 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA A100628) |
| Additional Taxonomies | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: CA A100628) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A100628) | |
| Enumeration Date | 2012-02-15 |
| Last Update Date | 2013-05-21 |