Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | 14977 | CA |
N | 2251E1200X | Ergonomics | 14977 | CA |
N | 225XE1200X | Ergonomics | 14977 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 14977 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 14977 | CA |
N | 2251S0007X | Physical Therapist - Sports | 14977 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 14977 | CA |
NPI | 1194823229 |
---|---|
Provider Name | Mr. Gonzalo Andres Cerda |
First Address | Northridge, CA 91326-1443 |
Second Address | Encino, CA 91436-2124 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2006 |
Last Update Date | 08/07/2007 |