Individual provider · Type 1 NPI
Ethan M. Kreiswirth, MA, ATC
Specialist · Carson, CA
NPI number
1336249978
Active
Practice location
Cal State Dominguez Hls, 1000 E. Victoria St.
Carson, CA 90747-0001
Mailing address
5361 W 126th St
Hawthorne, CA 90250-4128
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | None listed |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Other specialist providers in Carson
About NPI 1336249978
Ethan M. Kreiswirth, MA, ATC's National Provider Identifier is 1336249978, issued on Sep 24, 2006. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Carson, CA. The record was last updated on Jul 8, 2007.