Provider Demographics
NPI:1265501977
Name:PUNO, DENNIS JAMERO (RPT)
Entity Type:Individual
Prefix:MR
First Name:DENNIS
Middle Name:JAMERO
Last Name:PUNO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 E GREEN ST
Mailing Address - Street 2:SUITE 308
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2120
Mailing Address - Country:US
Mailing Address - Phone:626-356-0538
Mailing Address - Fax:626-356-0628
Practice Address - Street 1:750 E GREEN ST
Practice Address - Street 2:SUITE 308
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2120
Practice Address - Country:US
Practice Address - Phone:626-356-0538
Practice Address - Fax:626-356-0628
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT26331225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist