Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | PT298652 | CA |
NPI | 1003429267 |
---|---|
Provider Name | Nicholas Pasadis |
First Address | Santa Rosa, CA 95401-7120 |
Second Address | Santa Rosa, CA 95401-7120 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/08/2020 |
Last Update Date | 27/08/2020 |