| NPI | 1760361794 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COLETTE THILKEN Manager 949-533-0319 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| Enumeration Date | 2025-09-02 |
| Last Update Date | 2025-09-02 |