Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 35568 | CA |
NPI | 1003136482 |
---|---|
Provider Name | Miss Rachel Rebecca Buivids |
First Address | Fountain Valley, CA 92728-8125 |
Second Address | Fountain Valley, CA 92708-4210 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/06/2010 |
Last Update Date | 08/06/2010 |