| NPI | 1700298601 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR JASON CHANG COO 310-626-1533 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 204R00000X Electrodiagnostic Medicine (Licence: CA A84921) |
| 111N00000X Chiropractor | |
| 171100000X Acupuncturist | |
| 208100000X Physical Medicine & Rehabilitation | |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A84921) | |
| 2084B0040X Psychiatry & Neurology, Behavioral Neurology & Neuropsychiatry | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A84921) | |
| 363AM0700X Physician Assistant, Medical | |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2014-05-27 |
| Last Update Date | 2021-11-30 |