Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0100X | Occupational Health | DC-31268 | CA |
NPI | 1548579154 |
---|---|
Provider Name | Raquel G Palazzolo |
First Address | Pomona, CA 91766-1537 |
Second Address | Pomona, CA 91766-1537 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/09/2010 |
Last Update Date | 29/09/2010 |