Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT22760 | CA |
NPI | 1043302417 |
---|---|
Provider Name | John A. Kangas |
First Address | Santa Barbara, CA 93105-4350 |
Second Address | Santa Barbara, CA 93105-3309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2006 |
Last Update Date | 08/07/2007 |