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General NPI Number Information
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NPI Number | 1932111820
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Entity Type | Individual
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Provider Name | JOSEPH RONALDO ELUMBA MPT
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Gender | Male
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Dates
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Enumeration Date | 08/12/2006
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Last Update Date | 11/23/2022
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Provider Practice Location Address
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Address Line | 28 STYLE DR
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8090
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Country | US
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Telephone | 949-300-3423
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Fax | 949-215-1961
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Provider Business Mailing Address
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Address Line | 28 STYLE DR
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City | ALISO VIEJO
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State | CA
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Zip | 92656-8090
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Country | US
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Telephone | 949-700-1958
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Fax | 949-215-1961
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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 | 2251G0304X
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Taxonomy Name | Geriatric Physical Therapist
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License Number | PT22423
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT22423
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License Number State | CA
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