Provider Demographics
NPI:1154087617
Name:NORWOOD, CEDRIC D (DPT)
Entity Type:Individual
Prefix:
First Name:CEDRIC
Middle Name:D
Last Name:NORWOOD
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6869 COLORADO AVE
Mailing Address - Street 2:
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942-1109
Mailing Address - Country:US
Mailing Address - Phone:951-751-4488
Mailing Address - Fax:
Practice Address - Street 1:5905 SEVERIN DR
Practice Address - Street 2:
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91942-3806
Practice Address - Country:US
Practice Address - Phone:619-589-2606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-09
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA301451225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist