Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1013313410 |
---|---|
Provider Name | Paul Ramos |
First Address | Los Angeles, CA 90010-2501 |
Second Address | Los Angeles, CA 90010-2501 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/11/2014 |
Last Update Date | 12/11/2014 |