| NPI | 1982269080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAYMOND BENJAMIN RAVEN CEO 818-841-3936 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207XS0106X Orthopaedic Surgery Hand Surgery |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery |
| Enumeration Date | 2019-05-03 |
| Last Update Date | 2019-05-03 |