| NPI | 1528237187 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SCOTT DUONG Owner 310-396-5351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X (Licence: CA DC27749) |
| Additional Taxonomies | 2251S0007X Physical Therapist, Sports (Licence: CA PT34579) |
| Enumeration Date | 2008-02-27 |
| Last Update Date | 2008-07-31 |