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General NPI Number Information
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NPI Number | 1760678247
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Entity Type | Individual
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Provider Name | ANDREW MORCOS PT,DPT,SCS,OCS,ATC
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Gender | Male
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Dates
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Enumeration Date | 09/19/2007
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Last Update Date | 07/29/2016
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Provider Practice Location Address
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Address Line | 359 E PAYSON ST
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City | SAN DIMAS
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State | CA
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Zip | 91773-2221
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Country | US
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Telephone | 626-825-3739
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Fax |
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Provider Business Mailing Address
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Address Line | 359 E PAYSON ST
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City | SAN DIMAS
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State | CA
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Zip | 91773-2221
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Country | US
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Telephone | 626-825-3739
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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 | 2251X0800X
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Taxonomy Name | Orthopedic Physical Therapist
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License Number | 33997
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License Number State | CA
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