NPI | 1962504761 |
---|---|
Entity Type | Organization |
Authorized Contact | MARK JOHN SIMONSON Medical Director 805-585-0231 |
Organization Subpart ? | No |
Primary Taxonomy | 2081P2900X Physical Medicine & Rehabilitation, Pain Medicine |
Additional Taxonomies | 208VP0014X Pain Medicine, Interventional Pain Medicine |
Enumeration Date | 2006-09-02 |
Last Update Date | 2014-04-21 |