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NPI 1285567867

NPI 1285567867 : BENEDICT PAGCALIWANGAN : PASADENA, CA

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General NPI Number Information
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    NPI Number           |    1285567867
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    Entity Type          |    Individual 
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    Provider Name        |    BENEDICT PAGCALIWANGAN
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    06/04/2026
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    Last Update Date     |    06/04/2026
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Provider Practice Location Address
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    Address Line         |    345 S LAKE AVE STE 205 
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    City                 |    PASADENA
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    State                |    CA
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    Zip                  |    91101-5054
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    Country              |    US
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    Telephone            |    626-240-1060
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    Fax                  |    
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Provider Business Mailing Address
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    Address Line         |    3315 W HELLMAN AVE 
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    City                 |    ALHAMBRA
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    State                |    CA
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    Zip                  |    91803-2556
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    Country              |    US
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    Telephone            |    
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    Fax                  |    
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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        |    225700000X
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    Taxonomy Name        |    Massage Therapist
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    License Number       |    90268
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    License Number State |    CA
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