Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1023132602 |
---|---|
Provider Name | Heber Anguiano |
First Address | Pasadena, CA 91101-1403 |
Second Address | Long Beach, CA 90807-3529 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/03/2007 |
Last Update Date | 12/01/2022 |