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NPI Code Detail

MEDICARE: PATRICK JOSEPH BAGAN P.T.

MEDICARE:   PATRICK JOSEPH BAGAN  P.T.
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 Therapist36243CA

General Provider Information

NPI Number : 1144558487
Entity Type Code : Individual
Provider Name (Legal Business Name) : PATRICK JOSEPH BAGAN P.T.
Provider Business Mailing Address
First Line : 3178 HAMNER AVE # 4
Second Line :
City : NORCO
State : CA
Zip : 92860-1936
Country : US
Telephone Number : 951-736-5646
Fax Number : 951-736-5694
Provider Business Practice Location Address
First Line : 3178 HAMNER AVE # 4
Second Line :
City : NORCO
State : CA
Zip : 92860-1936
Country : US
Telephone Number : 951-736-5646
Fax Number : 951-736-5694
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/24/2009
Last Update Date : 02/11/2021

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Directions to “ PATRICK JOSEPH BAGAN P.T.” Practice Location

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