Healthcare Provider Details

I. General information

NPI: 1063784767
Provider Name (Legal Business Name): DENISE HIUGA DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/27/2012
Last Update Date: 01/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5478 WILSHIRE BLVD 208
LOS ANGELES CA
90036-4229
US

IV. Provider business mailing address

174 MONTEREY RD APT D
SOUTH PASADENA CA
91030-3552
US

V. Phone/Fax

Practice location:
  • Phone: 323-936-7525
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number38621
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: