Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251S0007X | Physical Therapist - Sports |
NPI | 1083262976 |
---|---|
Provider Name | Miss Lana Aziz-Oglii |
First Address | Los Alamitos, CA 90720-4905 |
Second Address | Los Alamitos, CA 90720-4905 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/09/2019 |
Last Update Date | 03/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0018779571 | KAISER (01) | CA |