| NPI | 1760921563 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY KAN Director 626-965-9078 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207PS0010X Emergency Medicine, Sports Medicine (Licence: CA c4858310) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: CA dc27615) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A98528) | |
| 208VP0000X (Licence: CA A69120) | |
| Enumeration Date | 2017-02-14 |
| Last Update Date | 2017-02-14 |