Provider Demographics
NPI:1235603853
Name:MURILLO, LAURA CATALINA (PT, DPT, ATC)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:CATALINA
Last Name:MURILLO
Suffix:
Gender:F
Credentials:PT, DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2820 N BELLFLOWER BLVD
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-1125
Mailing Address - Country:US
Mailing Address - Phone:562-384-4525
Mailing Address - Fax:562-384-4524
Practice Address - Street 1:2820 N BELLFLOWER BLVD
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90815-1125
Practice Address - Country:US
Practice Address - Phone:562-384-4525
Practice Address - Fax:562-384-4524
Is Sole Proprietor?:No
Enumeration Date:2019-01-16
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA304961225100000X
CA20000336242255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer