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Organization
PERFORMANCE CARE SPORTS MEDICINE & REHABILITATION CENTER, INC.
Active
Organization
PERFORMANCE CARE SPORTS MEDICINE & REHABILITATION CENTER, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GOLAN NISSIM DC (VP)
(818) 766-4307
Entity
Organization
Contact information
Practice address
10738 RIVERSIDE DRIVE, SUITE A, TOLUCA LAKE, CA 91602-2372
(818) 766-4307
(818) 766-4309
Mailing address
10738 RIVERSIDE DR STE A, TOLUCA LAKE, CA 91602-2372
(818) 766-4307
(818) 766-4309
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
DC25362
CA
207R00000X
Internal Medicine Physician
Primary
A42627
CA
Other
Enumeration date
06/05/2009
Last updated
11/20/2014
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