Provider Demographics
NPI:1104660729
Name:RIOS, VINCENT MICHAEL (DPT)
Entity type:Individual
Prefix:
First Name:VINCENT
Middle Name:MICHAEL
Last Name:RIOS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 CABRILLO AVE APT A
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90501-4621
Mailing Address - Country:US
Mailing Address - Phone:310-944-4599
Mailing Address - Fax:
Practice Address - Street 1:2615 PACIFIC COAST HWY STE 120
Practice Address - Street 2:
Practice Address - City:HERMOSA BEACH
Practice Address - State:CA
Practice Address - Zip Code:90254-2285
Practice Address - Country:US
Practice Address - Phone:310-933-3690
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-19
Last Update Date:2024-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic