Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 104100000X | Social Worker | 67321 | CA |
NPI | 1003228685 |
---|---|
Provider Name | Joseph Comer |
First Address | Long Beach, CA 90805-6510 |
Second Address | Long Beach, CA 90805-6510 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2014 |
Last Update Date | 26/10/2016 |