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NPI Code Detail

MEDICARE: ANGEL R EGGLESTON D.P.T

MEDICARE:   ANGEL R EGGLESTON  D.P.T
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical TherapistPT29583CA

General Provider Information

NPI Number : 1427202977
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEL R EGGLESTON D.P.T
Provider Business Mailing Address
First Line : 1800 E AROMA DR
Second Line : #120
City : WEST COVINA
State : CA
Zip : 91791-4030
Country : US
Telephone Number : 626-290-5208
Fax Number :
Provider Business Practice Location Address
First Line : 1800 E AROMA DR
Second Line : #120
City : WEST COVINA
State : CA
Zip : 91791-4030
Country : US
Telephone Number : 626-290-5208
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/11/2008
Last Update Date : 11/11/2008

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Directions to “ ANGEL R EGGLESTON D.P.T” Practice Location

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