| NPI | 1952025157 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PRICELDA CID Owner 310-920-9104 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0400X Clinic/Center Rehabilitation |
| Additional Taxonomies | 261QP2000X Clinic/Center Physical Therapy |
| 261QX0100X Clinic/Center Occupational Medicine | |
| Enumeration Date | 2022-09-30 |
| Last Update Date | 2023-08-25 |