| Doctor Name: | MR. PETER CARRILLO |
| NPI Number: | 1932124377 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PT |
| License Number: | PT26426 |
| Business Practice Address: | 1604 S Santa Fe Ave Suite 401 San Jacinto, CA - 925835060 |
| Business Phone Number: | 9514879317 |
| Business Fax Number: | 9514879371 |
| Mailing Address: | 38072 Amateur Way, BEAUMONT |
| State: | CA |
| Postal Code: | 922238086 |
| Phone Number: | 9094895971 |
| Fax Number: | |
| NPI Enumeration Date: | 07/13/2006 |
| NPI Last Update Date: | 04/12/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT26426 |
| 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 |