Lawantoro, Matthew

Lawantoro, Matthew is an individual health care provider with primary practice located at 12000 Mount Vernon Ave , Grand Terrace CA 92313-5174. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist, which is considered as his primary health care specialty. Lawantoro, Matthew can be contacted via phone (909) 825-5221.

Contact Information

Primary practice address
12000 Mount Vernon Ave Grand Terrace CA 92313-5174
Phone: (909) 825-5221
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Occupational Therapist 225X00000X 15625 California

Profile Details

NPI number 1073020210
LBN Legal business name Lawantoro, Matthew
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2018
Last updated Jan 9th, 2018 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1073020210 NPPES
California Other 15625 BOARD OF OCCUPATIONAL THERAPY

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