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General NPI Number Information
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NPI Number | 1689757627
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Entity Type | Individual
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Provider Name | TERRI M REMBUSKOS PA-C
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Gender | Female
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Dates
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Enumeration Date | 10/23/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4772 KATELLA AVE STE 200
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2683
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Country | US
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Telephone | 562-596-5552
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Fax | 562-596-5340
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Provider Business Mailing Address
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Address Line | 4772 KATELLA AVE STE 200
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City | LOS ALAMITOS
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State | CA
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Zip | 90720-2683
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Country | US
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Telephone | 562-596-5552
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Fax | 562-596-5340
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA17063
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License Number State | CA
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