Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 20A10372 | CA |
NPI | 1043309529 |
---|---|
Provider Name | Dr. Nathan Adam Perrizo |
First Address | Encinitas, CA 92024-1331 |
Second Address | Oceanside, CA 92056-4515 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/10/2006 |
Last Update Date | 15/06/2012 |