Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 19894 | CA |
NPI | 1225519960 |
---|---|
Provider Name | Ms. Doris Angela Paloma |
First Address | Rancho Palos Verdes, CA 90275-1803 |
Second Address | Rancho Palos Verdes, CA 90275-1803 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2018 |
Last Update Date | 21/08/2018 |