| NPI | 1780837005 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA THOMAS Billing Service Owner 858-504-0595 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: CA DC16468) |
| Additional Taxonomies | 111NR0400X Chiropractor Rehabilitation (Licence: CA DC16468) |
| 208100000X Physical Medicine & Rehabilitation (Licence: CA PT28268) | |
| 2081N0008X Physical Medicine & Rehabilitation Neuromuscular Medicine (Licence: CA PT28268) | |
| 2081P2900X Physical Medicine & Rehabilitation Pain Medicine (Licence: CA PT28268) | |
| Enumeration Date | 2008-10-30 |
| Last Update Date | 2008-10-30 |