Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 4760 | CA |
NPI | 1003024035 |
---|---|
Provider Name | Mr. Michael Matthew Ramirez |
First Address | Los Alamitos, CA 90720-3016 |
Second Address | Los Alamitos, CA 90720-3016 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/05/2007 |
Last Update Date | 08/07/2007 |