Provider Demographics
NPI:1376643627
Name:SALIB, KRISTINA M (PT)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M
Last Name:SALIB
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 COIT RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:PLANO
Mailing Address - State:TX
Mailing Address - Zip Code:75075-3768
Mailing Address - Country:US
Mailing Address - Phone:469-467-8705
Mailing Address - Fax:267-321-2550
Practice Address - Street 1:299 W FOOTHILL BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:UPLAND
Practice Address - State:CA
Practice Address - Zip Code:91786-3804
Practice Address - Country:US
Practice Address - Phone:909-985-2337
Practice Address - Fax:909-985-4694
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2021-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA26660225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ30106ZMedicare PIN
CAOPT266600Medicare PIN