| 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 | 2025-09-11 |