| NPI | 1689863714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHACK President 760-471-2033 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084N0400X Psychiatry & Neurology, Neurology (Licence: CA G26382) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA DC17617) |
| Enumeration Date | 2007-10-15 |
| Last Update Date | 2007-10-15 |