San Joaquin County Ccs in Manteca - Pediatrics
San Joaquin County Ccs - NPI 1639264005
San Joaquin County Ccs is a Pediatrics in Manteca, California. San Joaquin County Ccs practices all healthcare services and medical treatments related to Pediatrics. The NPI Number for San Joaquin County Ccs is 1639264005. The last update date is 2020-08-22.
San Joaquin County Ccs's current location address is 1810 Hoyt Ln, Manteca, California. You can contact this provider via phone number 2099825159. The mailing address for San Joaquin County Ccs is 1810 Hoyt Ln, Manteca, California. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | San Joaquin County Ccs |
|---|---|
| Address | 1810 Hoyt Ln, Manteca, California |
| Phone Number | 2099825159 |
| Fax Number | |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MTP MANAGE |
|---|---|
| Authorized Official Name | Valerio Armando |
| Credentials | PT,DPT |
| Telephone Number | 2099533617 |
NPI Number Detail
| NPI Number | 1639264005 |
|---|---|
| Provider Enumeration Date | 2006-10-03 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1810 Hoyt Ln |
|---|---|
| City | Manteca |
| State | California (CA) |
| Post Code | 953366354 |
| Phone Number | 2099825159 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Pediatrics |
|---|---|
| Taxonomy | 2251P0200X |
| Licence No | PT23512 |
|
Definition: A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Pediatric Physical Therapy, who has demonstrated specialized knowledge and skill in anatomy, histology, including embryonic development, |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| CCS00005F | CA | -- |
Post Comment/ Review Below
What is the San Joaquin County Ccs's 1639264005?
The San Joaquin County Ccs's NPI (National Provider Identifier) Number is 1639264005. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the San Joaquin County Ccs's physical address?
The San Joaquin County Ccs is physically located at 1810 Hoyt Ln, in the city of Manteca, CA, with the postal code 953366354.
What is San Joaquin County Ccs's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The San Joaquin County Ccs's specialized field of practice is Pediatrics, and the corresponding taxonomy code that categorizes this area of specialization is 2251P0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1639264005 to San Joaquin County Ccs?
The Centers for Medicare & Medicaid Services originally issued the 1639264005 to San Joaquin County Ccs on 2006-10-03.
When was the San Joaquin County Ccs's information last updated?
The San Joaquin County Ccs's information was last updated on 2020-08-22.