| NPI | 1790806230 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | THOMAS JACOB VAN DUSEN Owner, Partner 949-454-8811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 111NR0400X Chiropractor, Rehabilitation (Licence: CA DC-28755) |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician (Licence: CA DC-28726) |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2020-08-22 |