| NPI | 1578011599 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID S WILGARDE President 760-619-2309 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA G74463) |
| Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA G74463) |
| Enumeration Date | 2016-09-19 |
| Last Update Date | 2024-06-02 |