Healthcare Provider Details

I. General information

NPI: 1881598167
Provider Name (Legal Business Name): MAURICIO A PINEDA PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/08/2026
Last Update Date: 10/08/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2041 ROSECRANS AVE STE 375
EL SEGUNDO CA
90245-4796
US

IV. Provider business mailing address

2041 ROSECRANS AVE STE 375
EL SEGUNDO CA
90245-4796
US

V. Phone/Fax

Practice location:
  • Phone: 310-643-9401
  • Fax:
Mailing address:
  • Phone: 310-643-9401
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number310960
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: