Doctor Name: | DENISE DE GARCEAU |
NPI Number: | 1083643795 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | |
License Number: | |
Business Practice Address: | 520 N Prospect Ave Suite 100 Redondo Beach, CA - 902773041 |
Business Phone Number: | 3103769222 |
Business Fax Number: | |
Mailing Address: | 1514 Gates Ave, MANHATTAN BEACH |
State: | CA |
Postal Code: | 902667027 |
Phone Number: | 3103769222 |
Fax Number: | |
NPI Enumeration Date: | 07/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |