Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251X0800X | Physical Therapist - Orthopedic | 41057 | CA |
NPI | 1073928636 |
---|---|
Provider Name | Trevor Lapaglia |
First Address | Long Beach, CA 90822-5201 |
Second Address | Long Beach, CA 90822-5201 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2014 |
Last Update Date | 23/06/2014 |