| NPI | 1629002936 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANANT B DESAI Head Coach 714-646-8318 |
| Organization Subpart ? | No |
| Primary Taxonomy | 225100000X Physical Therapist |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 235Z00000X Speech-Language Pathologist | |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2010-04-02 |