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NPI Code Detail

MEDICARE: KATHERINE EUSTAQUIO PTA

MEDICARE: KATHERINE EUSTAQUIO PTA
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
1225200000XPhysical Therapy AssistantAT4910CA

General Provider Information

NPI Number : 1760555650
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHERINE EUSTAQUIO PTA
Provider Business Mailing Address
First Line : 13089 PEYTON DR # C134
Second Line :
City : CHINO HILLS
State : CA
Zip : 91709-6018
Country : US
Telephone Number : 909-973-2546
Fax Number :
Provider Business Practice Location Address
First Line : 17487 HURLEY ST
Second Line :
City : CITY OF INDUSTRY
State : CA
Zip : 91744-5106
Country : US
Telephone Number : 626-935-7723
Fax Number : 626-912-0072
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/16/2006
Last Update Date : 07/08/2007

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Directions to “ KATHERINE EUSTAQUIO PTA” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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