Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251G0304X | Physical Therapist - Geriatrics | 10851 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 10851 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 10851 | CA |
NPI | 1407255755 |
---|---|
Provider Name | Randall Gee |
First Address | Berkeley, CA 94708-1712 |
Second Address | Berkeley, CA 94708-1712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/08/2014 |
Last Update Date | 21/08/2014 |