| NPI | 1801327606 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MAXIM MORADIAN President/Owner 818-913-9356 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081S0010X Physical Medicine & Rehabilitation, Sports Medicine (Licence: CA A118692) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: CA A118692) |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine (Licence: CA A118692) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2021-03-22 |