Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports | PT293522 | CA |
NPI | 1396207544 |
---|---|
Provider Name | Dr. Rajpal Singh Brar |
First Address | Valencia, CA 91355-5503 |
Second Address | Valencia, CA 91355-5503 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/04/2019 |
Last Update Date | 06/04/2019 |