Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1902192461 |
---|---|
Provider Name | Leah Jean Delgadillo |
First Address | West Covina, CA 91792-1952 |
Second Address | Long Beach, CA 90822-5201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2011 |
Last Update Date | 17/12/2014 |