Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT26911 | CA |
NPI | 1689189235 |
---|---|
Provider Name | Mrs. Jill D See |
First Address | Irvine, CA 92697-0001 |
Second Address | Irvine, CA 92697-0001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/12/2017 |
Last Update Date | 05/12/2017 |