Individual
CHIVAN NGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1516 S MARENGO AVE, ALHAMBRA, CA 91803-3055
(626) 576-1032
Mailing address
3616 RIO HONDO AVE, ROSEMEAD, CA 91770-2041
(626) 264-2314
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT42022
CA
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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