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General NPI Number Information
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NPI Number | 1811051105
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Entity Type | Organization
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Legal Business Name | JULIAN P. YNIGUEZ PHYSICAL THERAPY, INC
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 591 S AZUSA WAY
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City | LA PUENTE
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State | CA
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Zip | 91744-5113
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Country | US
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Telephone | 626-964-5123
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Fax | 626-964-5105
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Provider Business Mailing Address
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Address Line | 591 S AZUSA WAY
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City | LA PUENTE
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State | CA
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Zip | 91744-5113
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Country | US
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Telephone | 626-964-5123
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Fax | 626-964-5105
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. JULIAN YNIGUEZ
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Credential | P.T.
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Telephone | 626-964-5123
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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 | PT26361
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License Number State | CA
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