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General NPI Number Information
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NPI Number | 1760508824
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Entity Type | Individual
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Provider Name | JULIAN PEREZ YNIGUEZ PHYSICAL THERAPY MPT
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Gender | Male
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 03/07/2017
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Provider Practice Location Address
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Address Line | 1220 HEMLOCK WAY STE 206
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City | SANTA ANA
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State | CA
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Zip | 92707-3650
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Country | US
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Telephone | 714-754-1990
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Fax | 714-242-9714
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Provider Business Mailing Address
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Address Line | 1559 HIGH BLUFF DR
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City | DIAMOND BAR
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State | CA
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Zip | 91765-2631
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Country | US
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Telephone | 909-861-8294
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Fax | 714-242-9714
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | PT26361
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License Number State | CA
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