Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111N00000X | Chiropractor | DC22123 | CA |
N | 111NI0013X | Independent Medical Examiner | DC22123 | CA |
NPI | 1669915567 |
---|---|
Provider Name | Renaldo P Pili |
First Address | El Monte, CA 91731-2533 |
Second Address | El Monte, CA 91731-2533 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/11/2016 |
Last Update Date | 23/11/2016 |