Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | OT 6025 | CA |
N | 225XH1200X | Occupational Therapist - Hand | OT 6025 | CA |
NPI | 1013054584 |
---|---|
Provider Name | Paul James Dimeglio |
First Address | Murrieta, CA 92562-6177 |
Second Address | Temecula, CA 92591-6200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/01/2007 |
Last Update Date | 03/03/2021 |