| NPI | 1760636351 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM BRADLEY SEVERSON CEO 760-325-4595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP3300X Clinic/Center, Pain (Licence: CA DC28533) |
| Enumeration Date | 2008-11-09 |
| Last Update Date | 2008-11-09 |