Healthcare Provider Details

I. General information

NPI: 1730098146
Provider Name (Legal Business Name): KEVIN S TOGATOROP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2026
Last Update Date: 09/02/2026
Certification Date: 09/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10620 MOUNTAIN VIEW AVE APT B
REDLANDS CA
92373-8427
US

IV. Provider business mailing address

10620 MOUNTAIN VIEW AVE APT B
REDLANDS CA
92373-8427
US

V. Phone/Fax

Practice location:
  • Phone: 909-252-0653
  • Fax:
Mailing address:
  • Phone: 909-252-0653
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License Number50552
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: