Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1578656336 |
---|---|
Provider Name | Mr. Steven Robert Gates |
First Address | Lancaster, CA 93535-4346 |
Second Address | Sepulveda, CA 91343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |