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Individual
RENE ANDRE MAILLARD
Active
Individual
RENE ANDRE MAILLARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.T.
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT24674
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0PT246740
BLUE SHIELD
CA
01
—
P00160372
RAIL ROAD MEDICARE
CA
Enumeration date
10/23/2006
Last updated
11/06/2025
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