Individual
CLARIZA AMPARO IBANEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPT
Contact information
Practice address
9652 BELCHER ST, DOWNEY, CA 90242-4811
(562) 803-1949
(562) 803-1949
Mailing address
9652 BELCHER ST, DOWNEY, CA 90242-4811
(562) 803-1949
(562) 803-1949
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT29742
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
WPT29742A
MEDICARE PPIN
CA
Enumeration date
10/02/2007
Last updated
10/02/2007
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