Healthcare Provider Details

I. General information

NPI: 1720012495
Provider Name (Legal Business Name): DENIS PAUL DEMPSEY P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2006
Last Update Date: 12/01/2021
Certification Date: 12/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2814 CAMINO DOS RIOS SUITE 406
NEWBURY PARK CA
91320-1134
US

IV. Provider business mailing address

2814 CAMINO DOS RIOS SUITE 406
NEWBURY PARK CA
91320-1134
US

V. Phone/Fax

Practice location:
  • Phone: 805-375-1461
  • Fax: 805-498-7613
Mailing address:
  • Phone: 805-375-1461
  • Fax: 805-498-7613

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number11942
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: