Provider Demographics
NPI:1275721995
Name:ANIAG, CHRISTIAN HERNANDEZ (DPT)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:HERNANDEZ
Last Name:ANIAG
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 1:23070 SISKIN CT
Mailing Address - Street 2:
Mailing Address - City:GRAND TERRACE
Mailing Address - State:CA
Mailing Address - Zip Code:92313-5338
Mailing Address - Country:US
Mailing Address - Phone:909-953-6713
Mailing Address - Fax:
Practice Address - Street 1:23070 SISKIN CT
Practice Address - Street 2:
Practice Address - City:GRAND TERRACE
Practice Address - State:CA
Practice Address - Zip Code:92313-5338
Practice Address - Country:US
Practice Address - Phone:909-953-6713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-09
Last Update Date:2007-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26420225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist