Organization
PERFORMANCE MEDICAL & REHAB CENTER
Active
Organization
PERFORMANCE MEDICAL & REHAB CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN D CARRICO (OWNER)
(310) 540-9699
Entity
Organization
Contact information
Practice address
21707 HAWTHORNE BLVD, SUITE 101, TORRANCE, CA 90503-7010
(310) 540-9699
(310) 540-9486
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
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Enumeration date
07/07/2008
Last updated
12/12/2012
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