Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | CA |
NPI | 1043550825 |
---|---|
Provider Name | Mr. Richard Lee Hopkins III |
First Address | Pomona, CA 91767-2722 |
Second Address | Pomona, CA 91767-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2013 |
Last Update Date | 17/01/2019 |