Provider Demographics
NPI:1437771086
Name:CARDONA, ARNOLD GAMBONG (RPT)
Entity Type:Individual
Prefix:MR
First Name:ARNOLD
Middle Name:GAMBONG
Last Name:CARDONA
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12210 CASTLEBAY PL
Mailing Address - Street 2:
Mailing Address - City:PORTER RANCH
Mailing Address - State:CA
Mailing Address - Zip Code:91326-1010
Mailing Address - Country:US
Mailing Address - Phone:917-815-9403
Mailing Address - Fax:
Practice Address - Street 1:12210 CASTLEBAY PL
Practice Address - Street 2:
Practice Address - City:PORTER RANCH
Practice Address - State:CA
Practice Address - Zip Code:91326-1010
Practice Address - Country:US
Practice Address - Phone:917-815-9403
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-16
Last Update Date:2020-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist