Provider Demographics
NPI:1871950881
Name:VALDEZ, ALMAR (PT ASSISTANT)
Entity type:Individual
Prefix:
First Name:ALMAR
Middle Name:
Last Name:VALDEZ
Suffix:
Gender:M
Credentials:PT ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3075 FOOTHILL BLVD UNIT 107
Mailing Address - Street 2:
Mailing Address - City:LA CRESCENTA
Mailing Address - State:CA
Mailing Address - Zip Code:91214-2787
Mailing Address - Country:US
Mailing Address - Phone:213-422-6640
Mailing Address - Fax:
Practice Address - Street 1:3075 FOOTHILL BOULEVARD
Practice Address - Street 2:UNIT 107
Practice Address - City:LA CERESCENTA
Practice Address - State:CA
Practice Address - Zip Code:91214
Practice Address - Country:US
Practice Address - Phone:213-422-6643
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-21
Last Update Date:2016-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA6431225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA2134226643Medicare PIN