Provider Demographics
NPI:1215172531
Name:LOCQUIAO, REYNALDO D (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:REYNALDO
Middle Name:D
Last Name:LOCQUIAO
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:655 S FLOWER ST
Mailing Address - Street 2:BOX 368
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90017-2805
Mailing Address - Country:US
Mailing Address - Phone:213-430-9180
Mailing Address - Fax:818-286-0288
Practice Address - Street 1:820 34TH ST
Practice Address - Street 2:SUITE# 100
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-2283
Practice Address - Country:US
Practice Address - Phone:661-636-0903
Practice Address - Fax:661-324-4844
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-16
Last Update Date:2008-12-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA33004174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist