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NPI Code Detail

MEDICARE: MR. RANDY NAVARRO ALICNA PT, DPT

MEDICARE: MR. RANDY NAVARRO ALICNA PT, 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 TherapistPT293751CA

General Provider Information

NPI Number : 1861094294
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. RANDY NAVARRO ALICNA PT, DPT
Provider Business Mailing Address
First Line : 3725 GARNET ST APT 229
Second Line :
City : TORRANCE
State : CA
Zip : 90503-3327
Country : US
Telephone Number : 415-299-4543
Fax Number :
Provider Business Practice Location Address
First Line : 774 S PLACENTIA AVE STE 200
Second Line :
City : PLACENTIA
State : CA
Zip : 92870-6838
Country : US
Telephone Number : 415-299-4543
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/10/2020
Last Update Date : 11/10/2020

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