Provider Demographics
NPI:1225505738
Name:DE GUIA, DEMI VICTORIA (DPT)
Entity Type:Individual
Prefix:
First Name:DEMI VICTORIA
Middle Name:
Last Name:DE GUIA
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8250 WOODMAN AVE BLDG 2
Mailing Address - Street 2:
Mailing Address - City:PANORAMA CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91402-5427
Mailing Address - Country:US
Mailing Address - Phone:818-375-4023
Mailing Address - Fax:818-375-3552
Practice Address - Street 1:8250 WOODMAN AVE BLDG 2
Practice Address - Street 2:
Practice Address - City:PANORAMA CITY
Practice Address - State:CA
Practice Address - Zip Code:91402
Practice Address - Country:US
Practice Address - Phone:818-375-4023
Practice Address - Fax:818-375-3552
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-01
Last Update Date:2021-10-27
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic