| NPI | 1902177231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERROLD C BUSTOS President 949-588-2190 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA A85842) |
| Enumeration Date | 2012-01-18 |
| Last Update Date | 2012-01-18 |