Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1023456472 |
---|---|
Provider Name | Aleta Lua |
First Address | Downey, CA 90241-0635 |
Second Address | Santa Fe Springs, CA 90670-3674 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2013 |
Last Update Date | 07/06/2013 |