Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1033238811 |
---|---|
Provider Name | Mrs. Claudia Calderon |
First Address | Los Angeles, CA 90042 |
Second Address | Los Angeles, CA 90040-2418 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |