Provider Demographics
NPI:1467557348
Name:MAGUIRE, CASEY EDWARD (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:MR
First Name:CASEY
Middle Name:EDWARD
Last Name:MAGUIRE
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 14155
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92863-1555
Mailing Address - Country:US
Mailing Address - Phone:310-218-2600
Mailing Address - Fax:310-541-8280
Practice Address - Street 1:8 QUAIL RIDGE RD S
Practice Address - Street 2:
Practice Address - City:ROLLING HILLS
Practice Address - State:CA
Practice Address - Zip Code:90274-5017
Practice Address - Country:US
Practice Address - Phone:310-218-2600
Practice Address - Fax:310-541-8280
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 24014225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist