Provider Demographics
NPI:1346232402
Name:ROUS, DAVID L (PT OCS)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:L
Last Name:ROUS
Suffix:
Gender:M
Credentials:PT OCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1201 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-2306
Mailing Address - Country:US
Mailing Address - Phone:661-327-4357
Mailing Address - Fax:661-327-2311
Practice Address - Street 1:3700 GOSFORD RD
Practice Address - Street 2:STE G
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93309-7694
Practice Address - Country:US
Practice Address - Phone:661-832-9737
Practice Address - Fax:661-832-9738
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2010-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA19919225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00113631OtherRAILROAD MEDICARE PTAN
CAZZZ21297ZOtherMEDICARE GROUP PTAN
CAZZZ21297ZOtherMEDICARE GROUP PTAN