Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033237748 |
---|---|
Provider Name | Louis Dawson |
First Address | Long Beach, CA 90804-5211 |
Second Address | Long Beach, CA 90802-2426 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/03/2007 |
Last Update Date | 31/05/2013 |