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NPI Code Detail

MEDICARE: ROCKY AMAGAN

MEDICARE: ROCKY AMAGAN
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
1225100000XPhysical Therapist40431CA

General Provider Information

NPI Number : 1548683220
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROCKY AMAGAN
Provider Business Mailing Address
First Line : 177 LARSEN CIR
Second Line :
City : VALLEJO
State : CA
Zip : 94589-1944
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2780 26TH AVE
Second Line :
City : OAKLAND
State : CA
Zip : 94601-1911
Country : US
Telephone Number : 510-533-3668
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2014
Last Update Date : 01/30/2014

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Directions to “ ROCKY AMAGAN ” Practice Location

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