Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | 291772 | CA |
NPI | 1154964245 |
---|---|
Provider Name | William Bernaldo |
First Address | Escondido, CA 92027-3854 |
Second Address | Escondido, CA 92027-3854 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2019 |
Last Update Date | 22/10/2019 |