Organization
PEPPERDINE UNIVERSITY
Active
Organization
PEPPERDINE UNIVERSITY
Active
Other names
Pepperdine Sports Medicine
Organization subpart
No
Provider details
NPI number
Authorized official
MOUZON BASS III (AGENT)
18005559073
Entity
Organization
Contact information
Practice address
24255 PACIFIC COAST HWY, MALIBU, CA 90263-3999
(310) 506-4602
(972) 367-3451
Mailing address
5050 SPRING VALLEY RD, DALLAS, TX 75244-3995
(800) 555-9073
(972) 367-3452
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
—
—
Other
Enumeration date
02/12/2015
Last updated
02/12/2015
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