Provider Demographics
NPI:1417151705
Name:ARTURO, ANGELINA MARIE (PT)
Entity Type:Individual
Prefix:
First Name:ANGELINA
Middle Name:MARIE
Last Name:ARTURO
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 1:23595 MOULTON PKWY STE E
Mailing Address - Street 2:
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-1939
Mailing Address - Country:US
Mailing Address - Phone:949-218-0853
Mailing Address - Fax:492-180-8569
Practice Address - Street 1:23595 MOULTON PKWY STE E
Practice Address - Street 2:
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-1939
Practice Address - Country:US
Practice Address - Phone:949-218-0853
Practice Address - Fax:949-218-0856
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT42670225100000X, 225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA232918467OtherAETNA
PA232918467OtherAETNA