Healthcare Provider Details

I. General information

NPI: 1023927092
Provider Name (Legal Business Name): ANGEL PINTO PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/03/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9610 NEW MORNING PL
RANCHO CUCAMONGA CA
91730-0985
US

IV. Provider business mailing address

9610 NEW MORNING PL
RANCHO CUCAMONGA CA
91730-0985
US

V. Phone/Fax

Practice location:
  • Phone: 909-992-9255
  • Fax:
Mailing address:
  • Phone: 909-992-9255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number53533
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: