| NPI | 1740201730 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATE J GRACE Owner 858-457-3545 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical (Licence: CA 473) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: CA 9486PT) |
| Enumeration Date | 2006-07-22 |
| Last Update Date | 2022-07-21 |