Provider Demographics
NPI:1316238454
Name:LINARES, RONALD OSVALDO (RPT, MPT)
Entity type:Individual
Prefix:MR
First Name:RONALD
Middle Name:OSVALDO
Last Name:LINARES
Suffix:
Gender:M
Credentials:RPT, MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2338 CORNFLOWER WAY
Mailing Address - Street 2:
Mailing Address - City:PALMDALE
Mailing Address - State:CA
Mailing Address - Zip Code:93551-6205
Mailing Address - Country:US
Mailing Address - Phone:818-633-5956
Mailing Address - Fax:
Practice Address - Street 1:44453 16TH ST W
Practice Address - Street 2:SUITE 103
Practice Address - City:LANCASTER
Practice Address - State:CA
Practice Address - Zip Code:93534-2802
Practice Address - Country:US
Practice Address - Phone:818-633-5956
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-24
Last Update Date:2011-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT33271225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist