| NPI | 1619110269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN JOHN COSTELLO President 805-217-4998 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A43746) |
| Enumeration Date | 2009-04-13 |
| Last Update Date | 2009-04-13 |