| NPI | 1760606537 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARL HYUN-GEOL SHIN Medical Director 916-977-0741 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A60900) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A60900) | |
| 332900000X Non-Pharmacy Dispensing Site (Licence: CA A60900) | |
| Enumeration Date | 2007-04-12 |
| Last Update Date | 2023-03-31 |