Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033356902 |
---|---|
Provider Name | Mr. Francisco Javier Perez |
First Address | Van Nuys, CA 91405-5643 |
Second Address | Granada Hills, CA 91344-6342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/01/2009 |
Last Update Date | 14/01/2009 |