Provider Demographics
NPI:1326844168
Name:BOJORQUEZ, MAXIMILIANO (PT DPT)
Entity type:Individual
Prefix:
First Name:MAXIMILIANO
Middle Name:
Last Name:BOJORQUEZ
Suffix:
Gender:
Credentials:PT DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:23100 EUCALYPTUS AVE STE C
Mailing Address - Street 2:
Mailing Address - City:MORENO VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92553-5439
Mailing Address - Country:US
Mailing Address - Phone:951-292-2310
Mailing Address - Fax:951-379-1501
Practice Address - Street 1:2091 W FLORIDA AVE STE 210
Practice Address - Street 2:
Practice Address - City:HEMET
Practice Address - State:CA
Practice Address - Zip Code:92545-4800
Practice Address - Country:US
Practice Address - Phone:951-658-0005
Practice Address - Fax:951-658-0009
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA307590225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist