| NPI | 1750622577 |
|---|---|
| Doing Business As | PERFORMANCE HEALTH MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KENNY HEINE VP Of Operations 858-964-1506 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: CA G45164) |
| Enumeration Date | 2013-03-04 |
| Last Update Date | 2013-03-04 |