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General NPI Number Information
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NPI Number | 1669907630
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Entity Type | Individual
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Provider Name | NOAH LAMADRID ATC
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Gender | Male
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Dates
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Enumeration Date | 04/26/2017
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Last Update Date | 04/13/2021
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Provider Practice Location Address
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Address Line | 1405 PARK BLVD
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City | SAN DIEGO
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State | CA
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Zip | 92101-4722
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Country | US
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Telephone | 808-651-3865
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Fax |
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Provider Business Mailing Address
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Address Line | 3675 BARNARD DR APT 259
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City | OCEANSIDE
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State | CA
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Zip | 92056-4019
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Country | US
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Telephone | 808-651-3865
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number |
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 2255A2300X
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Taxonomy Name | Athletic Trainer
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License Number | 2000035422
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License Number State |
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