Provider Demographics
NPI:1174857213
Name:RUSENESCU, VICTOR (DPT)
Entity Type:Individual
Prefix:
First Name:VICTOR
Middle Name:
Last Name:RUSENESCU
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 1:2135 WESTCLIFF DR
Mailing Address - Street 2:STE 203
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-5512
Mailing Address - Country:US
Mailing Address - Phone:714-256-5074
Mailing Address - Fax:714-256-0770
Practice Address - Street 1:2135 WESTCLIFF DR
Practice Address - Street 2:STE 203
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660-5512
Practice Address - Country:US
Practice Address - Phone:949-379-8400
Practice Address - Fax:949-264-2811
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2019-04-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA34018225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist