Provider Demographics
NPI:1306954375
Name:TRUTALLI, DARIN DAVID (MPT, CSCS)
Entity type:Individual
Prefix:MR
First Name:DARIN
Middle Name:DAVID
Last Name:TRUTALLI
Suffix:
Gender:M
Credentials:MPT, CSCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 N GILBERT ST
Mailing Address - Street 2:
Mailing Address - City:HEMET
Mailing Address - State:CA
Mailing Address - Zip Code:92543-4013
Mailing Address - Country:US
Mailing Address - Phone:951-658-9000
Mailing Address - Fax:
Practice Address - Street 1:235 N GILBERT ST
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92543-4013
Practice Address - Country:US
Practice Address - Phone:951-658-9000
Practice Address - Fax:951-658-9585
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26414225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PT264141Medicare PIN