| NPI | 1689357501 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRICELDA CID Owner 310-920-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Additional Taxonomies | 225X00000X Occupational Therapist |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2023-11-10 |