Individual provider · NPI-1

Roberto Santos Capistrano, PT

Physical Therapist · Diamond Bar, CA

NPI number1942911219
StatusActive
Last updated in NPPESDec 7, 2022

Details

NPI
1942911219
Entity type
Individual (NPI-1)
Name
Mr. Roberto Santos Capistrano
Credential
PT
Sex
Male
Sole proprietor
Yes
Enumeration date
Dec 7, 2022
Certification date
Dec 7, 2022
Last updated
Dec 7, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
225100000X Physical Therapist21567CAYes

Practice location

1046 Greycloud Ln
Diamond Bar, CA 91765-4219

Phone 909-964-9265

Mailing address

1046 Greycloud Ln
Diamond Bar, CA 91765-4219

Phone 909-964-9265

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