Provider Demographics
NPI:1407323744
Name:IMEL, ANNA LOREN (DPT)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:LOREN
Last Name:IMEL
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:ANNA
Other - Middle Name:LOREN
Other - Last Name:GOSSETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:40680 CALIFORNIA OAKS RD STE 2A
Mailing Address - Street 2:
Mailing Address - City:MURRIETA
Mailing Address - State:CA
Mailing Address - Zip Code:92562-5755
Mailing Address - Country:US
Mailing Address - Phone:951-894-4800
Mailing Address - Fax:951-894-4804
Practice Address - Street 1:40680 CALIFORNIA OAKS RD STE 2A
Practice Address - Street 2:
Practice Address - City:MURRIETA
Practice Address - State:CA
Practice Address - Zip Code:92562-5755
Practice Address - Country:US
Practice Address - Phone:951-894-4800
Practice Address - Fax:951-894-4804
Is Sole Proprietor?:No
Enumeration Date:2018-10-24
Last Update Date:2018-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist