Provider Demographics
NPI:1003513748
Name:PEIG, DAVID JIREH (OTR/L)
Entity Type:Individual
Prefix:
First Name:DAVID JIREH
Middle Name:
Last Name:PEIG
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:539 BOURDET ST
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-2606
Mailing Address - Country:US
Mailing Address - Phone:909-618-5309
Mailing Address - Fax:
Practice Address - Street 1:4300 GREEN RIVER RD STE 114
Practice Address - Street 2:
Practice Address - City:CORONA
Practice Address - State:CA
Practice Address - Zip Code:92878-2306
Practice Address - Country:US
Practice Address - Phone:951-382-4238
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA24596225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist