Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | PT12705 | CA |
NPI | 1326429374 |
---|---|
Provider Name | Mrs. Rosebelle Sotto |
First Address | San Diego, CA 92128-4252 |
Second Address | San Diego, CA 92127-3002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/06/2015 |
Last Update Date | 16/06/2015 |