Healthcare Provider Details

I. General information

NPI: 1548503071
Provider Name (Legal Business Name): DARWIN LUY CUENCA P.T., D.P.T.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/03/2013
Last Update Date: 03/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14212 EBONY WAY
WESTMINSTER CA
92683-3512
US

IV. Provider business mailing address

14212 EBONY WAY
WESTMINSTER CA
92683-3512
US

V. Phone/Fax

Practice location:
  • Phone: 917-756-1287
  • Fax:
Mailing address:
  • Phone: 917-756-1287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number41034
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number034087
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT-4164
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: