Healthcare Provider Details

I. General information

NPI: 1417081449
Provider Name (Legal Business Name): REGINALD COCIFFI-POINTDUJOUR PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: REGINALD POINTDUJOUR PT, DPT

II. Dates (important events)

Enumeration Date: 03/14/2007
Last Update Date: 05/02/2022
Certification Date: 05/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 OVERLAND AVE APT 8176
LOS ANGELES CA
90034-4546
US

IV. Provider business mailing address

3215 OVERLAND AVE APT 8176
LOS ANGELES CA
90034-4546
US

V. Phone/Fax

Practice location:
  • Phone: 323-300-4198
  • Fax:
Mailing address:
  • Phone: 323-300-4198
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number029143
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code2251N0400X
TaxonomyNeurology Physical Therapist
License Number35053
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: