Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | 52214 | CA |
NPI | 1033239090 |
---|---|
Provider Name | Mr. Ian Timothy Howard |
First Address | Los Angeles, CA 90035-2408 |
Second Address | Los Angeles, CA 90057-4303 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2007 |
Last Update Date | 17/02/2009 |