| NPI | 1871918474 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND BENJAMIN RAVEN President & CEO 818-841-3936 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery, Hand Surgery (Licence: CA A66365) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: CA A66365) |
| 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A66365) | |
| Enumeration Date | 2014-02-19 |
| Last Update Date | 2014-12-09 |