Provider Demographics
NPI:1972706745
Name:LUZ LONTOC PHYSICAL THERAPY, INC
Entity type:Organization
Organization Name:LUZ LONTOC PHYSICAL THERAPY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LUZ
Authorized Official - Middle Name:M
Authorized Official - Last Name:LONTOC-CADIZ
Authorized Official - Suffix:
Authorized Official - Credentials:PT
Authorized Official - Phone:562-682-7442
Mailing Address - Street 1:1007 W LA PALMA AVE
Mailing Address - Street 2:SUITE #4
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-3620
Mailing Address - Country:US
Mailing Address - Phone:562-682-7442
Mailing Address - Fax:562-596-0476
Practice Address - Street 1:1007 W LA PALMA AVE
Practice Address - Street 2:SUITE #4
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-3620
Practice Address - Country:US
Practice Address - Phone:562-682-7442
Practice Address - Fax:562-596-0476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-07
Last Update Date:2008-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA=========OtherEIN