| NPI | 1962075986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AIDAN MATHEW CLARKE CEO 619-210-9291 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine |
| Additional Taxonomies | 2084A0401X Psychiatry & Neurology, Addiction Medicine |
| 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine | |
| Enumeration Date | 2021-07-19 |
| Last Update Date | 2023-07-07 |