Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT27531 | CA |
NPI | 1083789200 |
---|---|
Provider Name | Mr. Alejandro Magallon |
First Address | Fresno, CA 93720-1483 |
Second Address | Fresno, CA 93720-2941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 03/01/2022 |