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General NPI Number Information
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NPI Number | 1770523979
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Entity Type | Organization
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Legal Business Name | THOMAS V DEGUZMAN, PT, A PROFESSIONAL CORP
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Dates
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Enumeration Date | 06/07/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 13372 NEWPORT AVE SUITE I
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City | TUSTIN
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State | CA
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Zip | 92780-3426
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Country | US
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Telephone | 714-832-7999
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Fax | 714-832-7081
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Provider Business Mailing Address
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Address Line | 13372 NEWPORT AVE SUITE I
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City | TUSTIN
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State | CA
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Zip | 92780-3426
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Country | US
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Telephone | 714-832-7999
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Fax | 714-832-7081
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | RAMONA LIPA DEGUZMAN
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Credential |
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Telephone | 626-918-1776
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2000X
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Taxonomy Name | Physical Therapy Clinic/Center
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License Number | PT14506
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License Number State | CA
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