| NPI | 1811992068 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAN PAUL MADDOX Medical Director 951-715-3963 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine (Licence: CA A32046) |
| Enumeration Date | 2005-06-15 |
| Last Update Date | 2008-04-20 |