Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 297316 | CA |
NPI | 1053953307 |
---|---|
Provider Name | Binh Nguyen |
First Address | Mentor, OH 44060-6542 |
Second Address | Oakland, CA 94611-5613 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/10/2019 |
Last Update Date | 08/10/2019 |