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NPI Code Detail

MEDICARE: JULIAN PENARANDA DPT

MEDICARE:   JULIAN  PENARANDA  DPT
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 Therapist3834NV

General Provider Information

NPI Number : 1649742941
Entity Type Code : Individual
Provider Name (Legal Business Name) : JULIAN PENARANDA DPT
Provider Business Mailing Address
First Line : 6167 ALLEN COVE CT
Second Line :
City : LAS VEGAS
State : NV
Zip : 89148-1799
Country : US
Telephone Number : 847-445-8126
Fax Number :
Provider Business Practice Location Address
First Line : 105 N PECOS RD STE 130
Second Line :
City : HENDERSON
State : NV
Zip : 89074-1995
Country : US
Telephone Number : 702-685-1607
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/26/2018
Last Update Date : 12/26/2018

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Directions to “ JULIAN PENARANDA DPT” Practice Location

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