MEDICARE: EMMANUEL TERBIO

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
1	2251G0304X	Geriatric Physical Therapist

General Provider Information

NPI Number	:	1629722459
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL TERBIO

Provider Business Mailing Address
First Line	:	11815 BERNARDO TERRACE APARTMENT E-202
Second Line	:	11815 BERNARDO TERRACE APARTMENT E-202
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-1978
Country	:	US
Telephone Number	:	808-783-3641
Fax Number	:

Provider Business Practice Location Address
First Line	:	11815 BERNARDO TERRACE APARTMENT E-202
Second Line	:	11815 BERNARDO TERRACE APARTMENT E-202
City	:	SAN DIEGO
State	:	CA
Zip	:	92128-1978
Country	:	US
Telephone Number	:	808-783-3641
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/10/2022
Last Update Date	:	02/10/2022

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Directions to “ EMMANUEL TERBIO ” Practice Location

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