Provider Demographics
NPI:1265038905
Name:ARCIBAL, REX-DAVID LALAP
Entity Type:Individual
Prefix:
First Name:REX-DAVID
Middle Name:LALAP
Last Name:ARCIBAL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3849 ALBURY AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90808-2045
Mailing Address - Country:US
Mailing Address - Phone:562-884-0577
Mailing Address - Fax:
Practice Address - Street 1:14772 PIPELINE AVE
Practice Address - Street 2:
Practice Address - City:CHINO HILLS
Practice Address - State:CA
Practice Address - Zip Code:91709-6027
Practice Address - Country:US
Practice Address - Phone:909-606-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-08
Last Update Date:2020-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPTA50734225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant