Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224Z00000X | Occupational Therapy Assistant | 1154 | CA |
NPI | 1023405941 |
---|---|
Provider Name | Daniel Hamilton |
First Address | West Covina, CA 91790-1244 |
Second Address | West Covina, CA 91790-1244 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2015 |
Last Update Date | 17/04/2015 |