| NPI | 1932445012 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL D PHILLIPS President 310-701-9497 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0000X Pain Medicine, Pain Medicine (Licence: CA C32413) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: CA C32413) |
| 207Q00000X Family Medicine (Licence: CA C32413) | |
| Enumeration Date | 2012-12-18 |
| Last Update Date | 2013-04-05 |