| NPI | 1538417381 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANA LYNN BALLOW President 818-640-3552 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0127X Surgery Trauma Surgery (Licence: CA 20A10299) |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-31 |