| NPI | 1760006712 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVAN BRUCE BERK President 310-888-8896 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 208D00000X General Practice |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2021-09-29 |