Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 35677 | CA |
NPI | 1003204306 |
---|---|
Provider Name | Ritchie Val Aguilera |
First Address | Los Angeles, CA 90041-1985 |
Second Address | Los Angeles, CA 90041-1985 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/01/2015 |
Last Update Date | 08/01/2015 |