| NPI | 1609760511 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GINGER JOHNSON Credentialing 818-294-2657 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2025-06-05 |
| Last Update Date | 2025-06-05 |