| NPI | 1639582471 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIK PAULSON Owner/Medical Director 909-468-2192 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: CA 20A13403) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA PT37454) |
| 363AM0700X Physician Assistant, Medical (Licence: CA PA17449) | |
| 111N00000X Chiropractor (Licence: CA DC30668) | |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2015-10-01 |