Provider Demographics
NPI:1831487842
Name:PATZER, RONALD G (CMT)
Entity Type:Individual
Prefix:MR
First Name:RONALD
Middle Name:G
Last Name:PATZER
Suffix:
Gender:M
Credentials:CMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5220 CLARK AVE STE 317
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2614
Mailing Address - Country:US
Mailing Address - Phone:562-257-8156
Mailing Address - Fax:
Practice Address - Street 1:5220 CLARK AVE STE 317
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2614
Practice Address - Country:US
Practice Address - Phone:562-257-8156
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-12
Last Update Date:2011-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2228225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist