| NPI | 1831707199 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ANATOL VASILEV Program Spare Holder VP 310-393-2225 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation |
| Additional Taxonomies | 111NS0005X Chiropractor, Sports Physician |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2020-08-06 |