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Individual

INDIRA ANN POLAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OT

Contact information

Practice address
9089 CLAIREMONT MESA BLVD STE 200, SAN DIEGO, CA 92123-1225
(800) 787-6787
Mailing address
751 CENTRAL PARK DR APT 2432, ROSEVILLE, CA 95678-3526
(530) 913-6851

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT8593
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
157462721
AR
Enumeration date
05/11/2007
Last updated
10/27/2015
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