Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225200000X | Physical Therapy Assistant | AT5106 | CA |
NPI | 1013306257 |
---|---|
Provider Name | Mrs. Socorro Duran |
First Address | Torrance, CA 90503-4307 |
Second Address | Torrance, CA 90503-4307 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2015 |
Last Update Date | 12/01/2015 |