Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 32984 | CA |
NPI | 1144425398 |
---|---|
Provider Name | Lori Michi Ginoza |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-1061 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/06/2007 |
Last Update Date | 17/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
32984 | PT LICENSE (01) | CA |