Doctor Name: | KEITH GANZON |
NPI Number: | 1538449368 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.P.T |
License Number: | PT37291 |
Business Practice Address: | 24198 Khan Dr Loma Linda, CA - 923544877 |
Business Phone Number: | 9096331278 |
Business Fax Number: | |
Mailing Address: | 24198 Khan Dr, LOMA LINDA |
State: | CA |
Postal Code: | 923544877 |
Phone Number: | 9096331278 |
Fax Number: | |
NPI Enumeration Date: | 08/24/2011 |
NPI Last Update Date: | 08/24/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT37291 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |