Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081S0010X | Sports Medicine | 6014 | NY |
N | 213ES0000X | Sports Medicine | 6014 | NY |
N | 2251S0007X | Physical Therapist - Sports | 6014 | NY |
Y | 2251X0800X | Physical Therapist - Orthopedic | 6014 | NY |
NPI | 1528389897 |
---|---|
Provider Name | Mr. Steve Crear |
First Address | Los Angeles, CA 90025-1052 |
Second Address | Los Angeles, CA 90025-1052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/06/2010 |
Last Update Date | 21/06/2010 |