Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT 25193 | CA |
NPI | 1346559952 |
---|---|
Provider Name | Mr. Babe Donato Prieto |
First Address | Pittsburg, CA 94565-7629 |
Second Address | Pittsburg, CA 94565-7629 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/09/2010 |
Last Update Date | 30/09/2010 |