Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1033561667 |
---|---|
Provider Name | Brenda E Beltran |
First Address | Culver City, CA 90232-2732 |
Second Address | Culver City, CA 90232-2732 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/07/2016 |
Last Update Date | 19/11/2018 |