MEDICARE: PETER CHIRICO

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
1	225100000X	Physical Therapist	PT8303	CA

General Provider Information

NPI Number	:	1366546970
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PETER CHIRICO

Provider Business Mailing Address
First Line	:	3901 LAS POSAS RD
Second Line	:	SUITE #7
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1502
Country	:	US
Telephone Number	:	805-987-6851
Fax Number	:	805-987-8045

Provider Business Practice Location Address
First Line	:	3901 LAS POSAS RD
Second Line	:	SUITE #7
City	:	CAMARILLO
State	:	CA
Zip	:	93010-1502
Country	:	US
Telephone Number	:	805-987-6851
Fax Number	:	805-987-8045

Authorized Official
Title or Position	:	OWNER ADMINISTRATOR
Name	:	MR. PETER CHIRICO
Credential	:	PT
Telephone Number	:	805-987-6851

Provider Enumeration Date	:	09/12/2006
Last Update Date	:	12/23/2008

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Directions to “PETER CHIRICO ” Practice Location

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