Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1023300258 |
---|---|
Provider Name | Elizabeth Duran |
First Address | Pasadena, CA 91105-2048 |
Second Address | Pacoima, CA 91331-1338 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2011 |
Last Update Date | 23/06/2016 |