Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | PT13737 | CA |
N | 2251E1200X | Ergonomics | PT13737 | CA |
N | 225XE1200X | Ergonomics | PT13737 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT13737 | CA |
NPI | 1013925544 |
---|---|
Provider Name | Mr. Alex M Youssefian |
First Address | Pasadena, CA 91104 |
Second Address | El Segundo, CA 90245-4475 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/08/2006 |
Last Update Date | 15/03/2012 |