| NPI | 1639258239 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANDALL CRAIG GREGSON Clinic Director 760-630-8400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: CA 20A8052) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC19135) |
| 111N00000X Chiropractor (Licence: CA DC25424) | |
| 225100000X Physical Therapist (Licence: CA PT26629) | |
| 225200000X Physical Therapy Assistant (Licence: CA AT2851) | |
| 363A00000X Physician Assistant (Licence: CA PA17862) | |
| Enumeration Date | 2006-11-03 |
| Last Update Date | 2010-03-18 |