| NPI | 1518224740 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK MASHOUR Medical Director 888-951-9511 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A72007) |
| Additional Taxonomies | 103T00000X Psychologist (Licence: CA PSY9462) |
| 111N00000X Chiropractor (Licence: CA 21702) | |
| 171100000X Acupuncturist (Licence: CA 13813) | |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA A79570) | |
| 213E00000X Podiatrist (Licence: CA 4540) | |
| Enumeration Date | 2012-04-12 |
| Last Update Date | 2012-04-12 |