| NPI | 1760994354 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TY HECKMAN Manager 661-706-9444 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: CA a38702) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: CA a63639) | |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2019-06-24 |