| NPI | 1629010319 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN OLSON Office Manager 805-643-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA G84131) |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA G84131) |
| 208D00000X General Practice (Licence: CA G84131) | |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2011-11-15 |