Individual
JARED AMGOTT-KWAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6116 MEDAU PL, OAKLAND, CA 94611-2809
(510) 339-2116
Mailing address
176 ATHOL AVE APT 1, OAKLAND, CA 94606-1737
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
50719
CA
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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