Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT8174A | CA |
NPI | 1003031915 |
---|---|
Provider Name | Janis B Dugan |
First Address | Solvang, CA 93463-2262 |
Second Address | Solvang, CA 93463-2262 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/04/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
W17211 | MC GROUP NUMBER (01) | CA |
WPT8174A | PPIN (01) | CA |