Provider Demographics
NPI:1093328064
Name:PASCUAL, CHRISTOPHER (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:
Last Name:PASCUAL
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 4TH AVE STE 301
Mailing Address - Street 2:
Mailing Address - City:CHULA VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:91910-4403
Mailing Address - Country:US
Mailing Address - Phone:619-409-3690
Mailing Address - Fax:619-409-3695
Practice Address - Street 1:480 4TH AVE STE 301
Practice Address - Street 2:
Practice Address - City:CHULA VISTA
Practice Address - State:CA
Practice Address - Zip Code:91910-4403
Practice Address - Country:US
Practice Address - Phone:619-409-3690
Practice Address - Fax:619-409-3695
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA298108225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist