| NPI | 1972616142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRY D. CARNES Office Manager 714-848-1911 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207XX0005X Orthopaedic Surgery, Sports Medicine (Licence: CA A82379) |
| Additional Taxonomies | 207XX0005X Orthopaedic Surgery, Sports Medicine |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2017-02-21 |