Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 28459 | CA |
NPI | 1003119587 |
---|---|
Provider Name | Dr. Alona Mary Yacobovsky |
First Address | San Diego, CA 92108-6542 |
Second Address | San Diego, CA 92108-6542 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/12/2010 |
Last Update Date | 09/08/2012 |