Healthcare Provider Details

I. General information

NPI: 1619846458
Provider Name (Legal Business Name): JERBEE ARMINSON LEONARDO GELLO-AGAN DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/31/2025
Last Update Date: 10/31/2025
Certification Date: 10/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 N GILBERT ST
HEMET CA
92543-4013
US

IV. Provider business mailing address

1785 VIBRANT GLN
SAN JACINTO CA
92582-2270
US

V. Phone/Fax

Practice location:
  • Phone: 951-658-9000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number308500
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: