Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XH1200X | Occupational Therapist - Hand | 1374 | CA |
NPI | 1144425877 |
---|---|
Provider Name | Mr. Fernando Palis Cabling |
First Address | Bonita, CA 91902-4029 |
Second Address | San Diego, CA 92123-1637 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2007 |
Last Update Date | 23/10/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
437855 | NBCOT (01) |