Doctor Name: | DEANNA VON IBSCH |
NPI Number: | 1033344833 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | PT 35295 |
Business Practice Address: | 11105 Knott Ave Suite A Cypress, CA - 906305137 |
Business Phone Number: | 7148937399 |
Business Fax Number: | |
Mailing Address: | 11105 Knott Ave, Suite A CYPRESS |
State: | CA |
Postal Code: | 906305137 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 05/21/2009 |
NPI Last Update Date: | 01/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251P0200X |
License Number: | PT 35295 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |