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General NPI Number Information
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NPI Number | 1447075650
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Entity Type | Organization
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Legal Business Name | NECESITO SPORTS THERAPY
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Dates
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Enumeration Date | 11/21/2024
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Last Update Date | 02/18/2025
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Provider Practice Location Address
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Address Line | 870 N DIAMOND BAR BLVD
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City | DIAMOND BAR
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State | CA
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Zip | 91765-1039
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Country | US
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Telephone | 909-993-3132
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Fax |
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Provider Business Mailing Address
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Address Line | 1261 N SYCAMORE AVE
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City | RIALTO
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State | CA
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Zip | 92376-3628
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Country | US
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Telephone | 909-993-3132
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | IAN CEDRICK NECESITO
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Credential | LMT, ST, PT
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Telephone | 909-993-3132
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2081S0010X
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Taxonomy Name | Sports Medicine (Physical Medicine & Rehabilitation) Physician
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License Number |
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License Number State |
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