Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225100000X | Physical Therapist | PT19840 | CA |
N | 2251E1200X | Ergonomics | PT19840 | CA |
N | 225XE1200X | Ergonomics | PT19840 | CA |
N | 2251S0007X | Physical Therapist - Sports | PT19840 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT19840 | CA |
NPI | 1538230347 |
---|---|
Provider Name | Robert A. Patterson |
First Address | Thousand Oaks, CA 91361-1201 |
Second Address | Thousand Oaks, CA 91361-1201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/11/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
S81676 | (02) | CA |