=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992998835
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | THOMAS JOSEPH NOTO JR. P.T.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/23/2007
-----------------------------------------------------
Last Update Date | 08/23/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1839 AZUL VIS
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92078-2111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-471-2918
-----------------------------------------------------
Fax | 760-471-2918
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1839 AZUL VIS
-----------------------------------------------------
City | SAN MARCOS
-----------------------------------------------------
State | CA
-----------------------------------------------------
Zip | 92078-2111
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 760-471-2918
-----------------------------------------------------
Fax | 760-471-2918
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 5048
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 2251G0304X
-----------------------------------------------------
Taxonomy Name | Geriatric Physical Therapist
-----------------------------------------------------
License Number | 5048
-----------------------------------------------------
License Number State | CA
-----------------------------------------------------