| NPI | 1679100622 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAO THAI NGIUYEN President 424-488-0500 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2020-03-26 |
| Last Update Date | 2020-04-03 |