Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225400000X | Rehabilitation Practitioner |
NPI | 1043677628 |
---|---|
Provider Name | Mrs. Evelyn Juliana Cumpian |
First Address | Los Angeles, CA 90021-1026 |
Second Address | Los Angeles, CA 90021-1026 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2016 |
Last Update Date | 27/07/2021 |