Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT9271 | CA |
N | 2251E1200X | Ergonomics | OT9271 | CA |
N | 225XE1200X | Ergonomics | OT9271 | CA |
N | 225XH1200X | Occupational Therapist - Hand | OT9271 | CA |
NPI | 1619163870 |
---|---|
Provider Name | Ian Chwen Hsien Goh |
First Address | San Diego, CA 92122-1177 |
Second Address | Chula Vista, CA 91910-3263 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/09/2007 |
Last Update Date | 21/09/2007 |