Doctor Name: | BYRON OMAR REYNOSO |
NPI Number: | 1164556700 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T. |
License Number: | 33535 |
Business Practice Address: | 2360 Cloverfield St Perris, CA - 925713300 |
Business Phone Number: | 9516601196 |
Business Fax Number: | |
Mailing Address: | 2360 Cloverfield St, PERRIS |
State: | CA |
Postal Code: | 925713300 |
Phone Number: | 9516601196 |
Fax Number: | |
NPI Enumeration Date: | 03/15/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2251X0800X |
License Number: | 33535 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | Orthopedic |
Taxonomy Definition: |