| NPI | 1679785695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER J CHARBONNET President 818-550-0900 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine Interventional Pain Medicine (Licence: CA G79131) |
| Enumeration Date | 2007-05-03 |
| Last Update Date | 2015-04-23 |