Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | AT 8181 | CA |
NPI | 1003074527 |
---|---|
Provider Name | Marites Machate |
First Address | San Francisco, CA 94115-2829 |
Second Address | San Francisco, CA 94115-2829 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2008 |
Last Update Date | 30/05/2008 |