NPI | 1568913671 |
---|---|
Entity Type | Organization |
Authorized Contact | DEREK TAN DEE President 310-408-5345 |
Organization Subpart ? | No |
Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA 65423) |
Additional Taxonomies | 111N00000X Chiropractor (Licence: CA 23165) |
Enumeration Date | 2016-10-24 |
Last Update Date | 2016-10-24 |