Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043760317 |
---|---|
Provider Name | John Zarate |
First Address | Van Nuys, CA 91411-2511 |
Second Address | Van Nuys, CA 91411-2511 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2016 |
Last Update Date | 17/10/2016 |