Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1275718892 |
---|---|
Provider Name | Fernando Jose Garcia |
First Address | Baldwin Park, CA 91706-4795 |
Second Address | Los Angeles, CA 90015-1329 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/01/2008 |
Last Update Date | 02/01/2008 |