Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225400000X | Rehabilitation Practitioner |
NPI | 1043514060 |
---|---|
Provider Name | Rodolfo Ramirez |
First Address | Los Angeles, CA 90020-1912 |
Second Address | Los Angeles, CA 90020-1912 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/01/2011 |
Last Update Date | 05/01/2011 |