| NPI | 1548323058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANNA C. LAWRENCE Office Manager 760-436-6882 |
| Organization Subpart ? | No |
| Primary Taxonomy | 204D00000X Neuromusculoskeletal Medicine & OMM (Licence: CA 20A5594) |
| Additional Taxonomies | 208D00000X General Practice (Licence: CA 20A5594) |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2008-02-13 |