| NPI | 1962076885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID ALEXANDER WARKENTIN Owner 310-770-6368 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208VP0014X Pain Medicine, Interventional Pain Medicine |
| Additional Taxonomies | 207LP2900X Anesthesiology, Pain Medicine |
| 207RA0401X Internal Medicine, Addiction Medicine | |
| 2084A0401X Psychiatry & Neurology, Addiction Medicine | |
| 2084P0802X Psychiatry & Neurology, Addiction Psychiatry | |
| 208VP0000X Pain Medicine, Pain Medicine | |
| Enumeration Date | 2021-05-15 |
| Last Update Date | 2022-02-14 |