Provider Demographics
NPI:1083988554
Name:MACAYAON, DAVID L
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:L
Last Name:MACAYAON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10317 NEWVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:DOWNEY
Mailing Address - State:CA
Mailing Address - Zip Code:90241-3038
Mailing Address - Country:US
Mailing Address - Phone:714-801-5799
Mailing Address - Fax:
Practice Address - Street 1:1801 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE #203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4641
Practice Address - Country:US
Practice Address - Phone:310-287-3711
Practice Address - Fax:310-287-3717
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-01
Last Update Date:2021-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 38670225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist