Provider Demographics
NPI:1073829792
Name:PAUIG, PABLO MALANA II (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:PABLO
Middle Name:MALANA
Last Name:PAUIG
Suffix:II
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 1:2361 SUMMERWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93063-6023
Mailing Address - Country:US
Mailing Address - Phone:310-497-6876
Mailing Address - Fax:805-522-2434
Practice Address - Street 1:2361 SUMMERWOOD AVE
Practice Address - Street 2:
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93063-6023
Practice Address - Country:US
Practice Address - Phone:310-497-6876
Practice Address - Fax:805-522-2434
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA4434225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist