Provider Demographics
NPI:1437126760
Name:MAOZ, IRIS (PT)
Entity Type:Individual
Prefix:
First Name:IRIS
Middle Name:
Last Name:MAOZ
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 1:450 N WIGET LN
Mailing Address - Street 2:
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2408
Mailing Address - Country:US
Mailing Address - Phone:925-691-9806
Mailing Address - Fax:925-691-9807
Practice Address - Street 1:2485 HIGH SCHOOL AVE
Practice Address - Street 2:SUITE 201
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-1819
Practice Address - Country:US
Practice Address - Phone:925-691-9806
Practice Address - Fax:925-691-9807
Is Sole Proprietor?:No
Enumeration Date:2006-03-06
Last Update Date:2013-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT20826225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist