Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XN1300X | Occupational Therapist - Neurorehabilitation |
NPI | 1467081828 |
---|---|
Provider Name | Mr. Fran Allas |
First Address | Pomona, CA 91767-2918 |
Second Address | Pomona, CA 91767-2918 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/04/2020 |
Last Update Date | 06/04/2020 |