Provider Demographics
NPI:1447978069
Name:ZEMBAL, MATTHEW GREGORY (DPT)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:GREGORY
Last Name:ZEMBAL
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11852 SILVER LOOP
Mailing Address - Street 2:
Mailing Address - City:JURUPA VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:91752-4400
Mailing Address - Country:US
Mailing Address - Phone:562-822-0692
Mailing Address - Fax:
Practice Address - Street 1:5214 E LOS ALTOS PLZ
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-4251
Practice Address - Country:US
Practice Address - Phone:562-597-3035
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302512225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist