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NPI Code Detail

MEDICARE: JOSEPH CANGAYO

MEDICARE: JOSEPH CANGAYO
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 AssistantAT10135CA

General Provider Information

NPI Number : 1770972077
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH CANGAYO
Provider Business Mailing Address
First Line : 3724 VETERAN AVE APT 1
Second Line :
City : LOS ANGELES
State : CA
Zip : 90034-7042
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 8167 W 3RD ST
Second Line :
City : LOS ANGELES
State : CA
Zip : 90048-4314
Country : US
Telephone Number : 626-428-9901
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/10/2015
Last Update Date : 01/10/2015

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Directions to “ JOSEPH CANGAYO ” Practice Location

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