Doctor Name: | RODOLFO MEDINA |
NPI Number: | 1710044193 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | 28819 |
Business Practice Address: | 16111 Plummer St Sepulveda, CA - 913432036 |
Business Phone Number: | 8188917711 |
Business Fax Number: | 8188959458 |
Mailing Address: | 19152 Kittridge St, RESEDA |
State: | CA |
Postal Code: | 913355894 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/03/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 28819 |
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 |