Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 41072 | CA |
NPI | 1396134995 |
---|---|
Provider Name | Alex Agpasa |
First Address | Orlando, FL 32817-8373 |
Second Address | Sunnyvale, CA 94087-3031 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/01/2015 |
Last Update Date | 30/04/2019 |