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General NPI Number Information
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NPI Number | 1477834687
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Entity Type | Individual
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Provider Name | DANIELA STOIMENOVA HRISTOVA PTA
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Gender | Female
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Dates
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Enumeration Date | 08/31/2011
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Last Update Date | 08/31/2011
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Provider Practice Location Address
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Address Line | 9441 SHADWELL DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7213
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Country | US
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Telephone | 714-930-5878
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Fax | 888-257-1807
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Provider Business Mailing Address
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Address Line | 9441 SHADWELL DR
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City | HUNTINGTON BEACH
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State | CA
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Zip | 92646-7213
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Country | US
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Telephone | 714-930-5878
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Fax | 888-257-1807
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | AT4310
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License Number State | CA
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