Provider Demographics
NPI:1871378125
Name:RECINOS, JAMES EDOARDO (DPT)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:EDOARDO
Last Name:RECINOS
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1845 BUSINESS CENTER DR STE 127
Mailing Address - Street 2:
Mailing Address - City:SAN BERNARDINO
Mailing Address - State:CA
Mailing Address - Zip Code:92408-3434
Mailing Address - Country:US
Mailing Address - Phone:909-890-9030
Mailing Address - Fax:909-890-4393
Practice Address - Street 1:3400 CENTRAL AVE STE 145
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92506-2161
Practice Address - Country:US
Practice Address - Phone:951-297-3399
Practice Address - Fax:951-297-3404
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2023-09-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA304676225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist