| NPI | 1811958747 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY MITCHELL Direct Owner 818-888-7815 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: CA G55977) |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine (Licence: CA G55977) |
| Enumeration Date | 2006-03-30 |
| Last Update Date | 2022-11-28 |