| NPI | 1588028625 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRYCE MATTHEWS Minority Owner 818-786-5985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA A102275) |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2016-04-05 |
| Last Update Date | 2017-04-03 |