Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0200X | Occupational Therapist - Pediatrics | 22797 | CA |
NPI | 1043974777 |
---|---|
Provider Name | Wesley Chow |
First Address | Castro Valley, CA 94552-5351 |
Second Address | Las Vegas, NV 89108-4578 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/10/2021 |
Last Update Date | 28/10/2021 |