| NPI | 1639611445 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMLIEN TRAN Manager 858-717-0088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine |
| Enumeration Date | 2016-11-10 |
| Last Update Date | 2016-11-10 |