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General NPI Number Information
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NPI Number | 1750103818
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Entity Type | Individual
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Provider Name | ARTHUR RAQUINO
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Gender | Male
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 11614 183RD ST
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City | ARTESIA
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State | CA
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Zip | 90701-5506
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Country | US
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Telephone | 562-865-5218
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Fax |
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Provider Business Mailing Address
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Address Line | 12614 LUCAS ST
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City | CERRITOS
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State | CA
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Zip | 90703-1124
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Country | US
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Telephone |
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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 | 29610
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License Number State | CA
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