Provider Demographics
NPI:1912640053
Name:KUIOKA, TROY HIRO (PT, DPT)
Entity type:Individual
Prefix:MR
First Name:TROY
Middle Name:HIRO
Last Name:KUIOKA
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10325 CAMINITO CUERVO UNIT 190
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1809
Mailing Address - Country:US
Mailing Address - Phone:808-721-7538
Mailing Address - Fax:
Practice Address - Street 1:3780 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941-7638
Practice Address - Country:US
Practice Address - Phone:619-465-1313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-17
Last Update Date:2022-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA42665225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist