Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | A118673 | CA |
NPI | 1013233576 |
---|---|
Provider Name | Mauro Walsh Zappaterra |
First Address | Pasadena, CA 91105-2699 |
Second Address | Pasadena, CA 91105-2699 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2010 |
Last Update Date | 26/06/2020 |