Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner | B7619540 | CA |
NPI | 1023287315 |
---|---|
Provider Name | Mrs. Karla P. Carbajal |
First Address | Los Angeles, CA 90031 |
Second Address | Los Angeles, CA 90031-2703 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/02/2008 |
Last Update Date | 21/02/2008 |