Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225000000X | Orthotic Fitter | C16152 | MD |
NPI | 1003081951 |
---|---|
Provider Name | Carlos Garces |
First Address | Northridge, CA 91326-3540 |
Second Address | Northridge, CA 91326-3540 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/04/2008 |
Last Update Date | 19/02/2013 |