Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 291946 | CA |
NPI | 1003265398 |
---|---|
Provider Name | Dr. Dorian Danic |
First Address | South Pasadena, CA 91030 |
Second Address | Los Angeles, CA 90033-1061 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2016 |
Last Update Date | 24/08/2016 |