Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | PT10007 | CA |
NPI | 1033229133 |
---|---|
Provider Name | Jonathan Holtz |
First Address | Capitola, CA 95010 |
Second Address | Capitola, CA 95010 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 21/04/2015 |