NPI | 1699123737 |
---|---|
Entity Type | Organization |
Authorized Contact | ILDAR FAZULYANOV Chief Operating Officer 310-384-0970 |
Organization Subpart ? | No |
Primary Taxonomy | 363L00000X Nurse Practitioner |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2016-05-31 |
Last Update Date | 2021-03-08 |