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General NPI Number Information
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NPI Number | 1538598818
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Entity Type | Individual
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Provider Name | DONALD KUSKIN PHYSICAL THERAPIST
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Gender | Male
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Dates
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Enumeration Date | 11/06/2013
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Last Update Date | 12/18/2013
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Provider Practice Location Address
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Address Line | 2492 WALNUT AVE #140
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City | TUSTIN
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State | CA
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Zip | 92780-6953
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Country | US
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Telephone | 714-544-2188
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Fax | 714-544-2189
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Provider Business Mailing Address
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Address Line | 18090 SANTA ARABELLA ST
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City | FOUNTAIN VALLEY
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State | CA
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Zip | 92708-5506
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Country | US
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Telephone | 440-725-9600
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 29129
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License Number State | CA
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