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General NPI Number Information
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NPI Number | 1083810683
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Entity Type | Individual
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Provider Name | GINA A. CAQUEZ
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Gender | Female
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Dates
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Enumeration Date | 06/21/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 12482 WASHINGTON BLVD
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City | WHITTIER
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State | CA
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Zip | 90602-1005
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Country | US
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Telephone | 562-693-6011
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Fax | 562-693-6012
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Provider Business Mailing Address
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Address Line | 24 HAMMOND STE C
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City | IRVINE
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State | CA
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Zip | 92618-1680
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Country | US
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Telephone | 949-770-6022
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Fax | 949-770-7084
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 33695
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License Number State | CA
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