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General NPI Number Information
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NPI Number | 1609102557
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Entity Type | Organization
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Legal Business Name | MARTHA CERDA, INC.
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Dates
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Enumeration Date | 10/28/2009
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Last Update Date | 02/05/2010
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Provider Practice Location Address
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Address Line | 7212 ORANGETHORPE AVE SUITE 3
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City | BUENA PARK
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State | CA
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Zip | 90621-3341
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Country | US
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Telephone | 714-562-0966
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Fax | 888-789-3197
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Provider Business Mailing Address
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Address Line | 7212 ORANGETHORPE AVE SUITE 3
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City | BUENA PARK
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State | CA
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Zip | 90621-3341
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Country | US
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Telephone | 714-562-0966
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Fax | 888-789-3197
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARTHA CERDA
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Credential | RPT, PA-C
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Telephone | 714-562-0966
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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 | PT18734
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License Number State | CA
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