Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT35351 | CA |
NPI | 1053559120 |
---|---|
Provider Name | Mr. Bryan Ernest Templeman |
First Address | Oakland, CA 94611-5883 |
Second Address | Oakland, CA 94611-5883 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2009 |
Last Update Date | 28/01/2009 |