| NPI | 1821680174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY SU President 626-260-5015 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083S0010X Preventive Medicine Sports Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center Health Service |
| 261QP2000X Clinic/Center Physical Therapy | |
| 261QR0400X Clinic/Center Rehabilitation | |
| Enumeration Date | 2021-02-08 |
| Last Update Date | 2021-02-08 |