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General NPI Number Information
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NPI Number | 1700943875
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Entity Type | Organization
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Legal Business Name | ANACAYA PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 01/02/2007
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 1365 STEIN WAY
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City | CORONA
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State | CA
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Zip | 92882-6063
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Country | US
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Telephone | 951-737-1328
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Fax | 951-848-0564
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Provider Business Mailing Address
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Address Line | 1365 STEIN WAY
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City | CORONA
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State | CA
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Zip | 92882-6063
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Country | US
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Telephone | 951-737-1328
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Fax | 951-848-0564
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Authorized Official
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Title or Position | PHYSICAL THERAPIST, OWNER
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Name | MR. CALVIN T. ANACAYA
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Credential | R.P.T.
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Telephone | 951-737-1328
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | PT25820
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License Number State | CA
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