| NPI | 1851322028 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY L MANSOOR President 209-944-5550 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine, Pain Medicine |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2021-03-08 |