Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 3017 | CA |
NPI | 1225363542 |
---|---|
Provider Name | Mr. Duane Edward Pompanescu |
First Address | Escondido, CA 92026-1201 |
Second Address | Escondido, CA 92026-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2009 |
Last Update Date | 05/10/2009 |