Healthcare Provider Details

I. General information

NPI: 1548647027
Provider Name (Legal Business Name): RAYMUND ALMENDARES PT ASSISSTANT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/04/2015
Last Update Date: 05/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 ELM VISTA DR APARTMENT A
DOWNEY CA
90242-5316
US

IV. Provider business mailing address

9228 ELM VISTA DR APARTMENT A
DOWNEY CA
90242-5316
US

V. Phone/Fax

Practice location:
  • Phone: 562-291-9378
  • Fax: 562-381-0058
Mailing address:
  • Phone: 562-291-9378
  • Fax: 562-381-0058

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number6801
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: