| NPI | 1578379228 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLIE TUASON Director Of Nursing 818-348-7246 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine |
| Additional Taxonomies | 261QA1903X Clinic/Center Ambulatory Surgical |
| 207XS0117X Orthopaedic Surgery Orthopaedic Surgery of the Spine | |
| Enumeration Date | 2024-12-07 |
| Last Update Date | 2025-02-28 |