| NPI | 1912460874 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY DAMATO Contracts Manager 805-264-3388 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
| Enumeration Date | 2019-04-08 |
| Last Update Date | 2019-04-08 |