Provider Demographics
NPI:1285787283
Name:GORMAN, ROBERT GLENN (PT DPT)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:GLENN
Last Name:GORMAN
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Gender:M
Credentials:PT DPT
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Mailing Address - Street 1:24221 CALLE DE LA LOUISA
Mailing Address - Street 2:SUITE 400
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-7638
Mailing Address - Country:US
Mailing Address - Phone:949-465-8155
Mailing Address - Fax:949-465-8159
Practice Address - Street 1:23961 CALLE DE LA MAGDALENA
Practice Address - Street 2:SUITE 400
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-3616
Practice Address - Country:US
Practice Address - Phone:949-587-1155
Practice Address - Fax:949-465-8159
Is Sole Proprietor?:No
Enumeration Date:2007-01-21
Last Update Date:2011-09-29
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Provider Licenses
StateLicense IDTaxonomies
CAPT 24587225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist