| NPI | 1669724696 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREEM SHAARAWY President 858-337-2452 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QS0010X Family Medicine, Sports Medicine (Licence: AZ 45249) |
| Additional Taxonomies | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA A120807) |
| Enumeration Date | 2012-10-15 |
| Last Update Date | 2012-10-15 |