Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XH1200X | Occupational Therapist - Hand | 0119007291 | VA |
N | 225XH1200X | Occupational Therapist - Hand | 110584 | TX |
Y | 225XH1200X | Occupational Therapist - Hand | 19391 | CA |
NPI | 1053564872 |
---|---|
Provider Name | Pradipta Kumar Sahu |
First Address | Lakewood, CA 90712-1521 |
Second Address | Lakewood, CA 90712-1521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2008 |
Last Update Date | 06/10/2020 |