| NPI | 1952543316 |
|---|---|
| Doing Business As | BODYLOGICMD OF IRVINE |
| Entity Type | Organization |
| Authorized Contact | MICHAEL JACK GROSSMAN Owner 949-222-0232 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2020-05-06 |