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General NPI Number Information
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NPI Number | 1972073724
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Entity Type | Individual
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Provider Name | JESUS Q FELIX JR.
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Gender | Male
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Dates
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Enumeration Date | 12/04/2018
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Last Update Date | 12/04/2018
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Provider Practice Location Address
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Address Line | 215 N STATE COLLEGE BLVD STE G
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City | ANAHEIM
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State | CA
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Zip | 92806-2932
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Country | US
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Telephone | 714-999-6596
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Fax |
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Provider Business Mailing Address
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Address Line | 13529 COBBLESTONE LN
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City | WESTMINSTER
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State | CA
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Zip | 92683-2375
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Country | US
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Telephone | 253-267-4897
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | PTA49520
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License Number State | CA
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