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NPI Code Detail

MEDICARE: JOHN A. KANGAS MPT

MEDICARE: JOHN A. KANGAS MPT
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12251X0800XOrthopedic Physical TherapistPT22760CA

General Provider Information

NPI Number : 1043302417
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN A. KANGAS MPT
Provider Business Mailing Address
First Line : 2504 CASTILLO ST APT 4
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-4350
Country : US
Telephone Number : 949-702-0799
Fax Number :
Provider Business Practice Location Address
First Line : 2921 DE LA VINA ST
Second Line :
City : SANTA BARBARA
State : CA
Zip : 93105-3309
Country : US
Telephone Number : 805-898-1907
Fax Number : 805-687-8121
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2006
Last Update Date : 07/08/2007

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