Provider Demographics
NPI:1306937545
Name:GASKILL, STEVE ALLEN (PT)
Entity type:Individual
Prefix:
First Name:STEVE
Middle Name:ALLEN
Last Name:GASKILL
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6024 WALNUT AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90805-3665
Mailing Address - Country:US
Mailing Address - Phone:213-422-6556
Mailing Address - Fax:562-422-3360
Practice Address - Street 1:6024 WALNUT AVE
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90805-3665
Practice Address - Country:US
Practice Address - Phone:213-422-6556
Practice Address - Fax:562-422-3360
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist