| NPI | 1760762785 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERIBERTO CASILLAS Director Sports Medicine 760-209-4419 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2000X Clinic/Center Physical Therapy |
| Enumeration Date | 2011-08-22 |
| Last Update Date | 2016-12-28 |