Provider Demographics
NPI:1164518189
Name:AMORMINO, GINELLE CARA (DPT)
Entity Type:Individual
Prefix:DR
First Name:GINELLE
Middle Name:CARA
Last Name:AMORMINO
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:DR
Other - First Name:GINELLE
Other - Middle Name:CARA
Other - Last Name:AMORMINO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DPT
Mailing Address - Street 1:2842 SEPULVEDA BLVD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-2803
Mailing Address - Country:US
Mailing Address - Phone:310-325-0800
Mailing Address - Fax:310-325-7705
Practice Address - Street 1:2842 SEPULVEDA BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-2803
Practice Address - Country:US
Practice Address - Phone:310-325-0800
Practice Address - Fax:310-325-7705
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16657Medicare UPIN
CAWPT28576AMedicare UPIN