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Organization

PERFORMANCE MEDICAL & REHAB CENTER

Active
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Organization

PERFORMANCE MEDICAL & REHAB CENTER

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN D. CAMICO D.C. (OWNER)
(310) 540-9699
Entity
Organization

Contact information

Practice address
13252 GARDEN GROVE BLVD., SUITE 112, GARDEN GROVE, CA 92843
(714) 740-1778
(714) 740-1913
Mailing address
21707 HAWTHORNE BLVD., SUITE 201, TORRANCE, CA 90503-7010
(310) 540-9699
(310) 540-9486

Taxonomy

Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—

Other

Enumeration date
08/11/2008
Last updated
08/11/2008
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