Provider Demographics
NPI:1306255443
Name:HAWKINS, ERIC GALEN (DPT)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:GALEN
Last Name:HAWKINS
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 1:1309 S SANDY HILL DR
Mailing Address - Street 2:
Mailing Address - City:WEST COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91791-3752
Mailing Address - Country:US
Mailing Address - Phone:626-833-7192
Mailing Address - Fax:
Practice Address - Street 1:1309 S SANDY HILL DR
Practice Address - Street 2:
Practice Address - City:WEST COVINA
Practice Address - State:CA
Practice Address - Zip Code:91791-3752
Practice Address - Country:US
Practice Address - Phone:626-833-7192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-02
Last Update Date:2014-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 41427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist