Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225000000X | Orthotic Fitter | RFOM 0103 |
NPI | 1891961793 |
---|---|
Provider Name | Sharon L Gomez |
First Address | Oakland, CA 94609-1310 |
Second Address | Concord, CA 94520-5789 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2008 |
Last Update Date | 01/05/2008 |