Provider Demographics
NPI:1487845061
Name:AQUINO, CEFERINO BORJA III (PT)
Entity Type:Individual
Prefix:MR
First Name:CEFERINO
Middle Name:BORJA
Last Name:AQUINO
Suffix:III
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1457 W CHENNAULT AVE
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93711-0515
Mailing Address - Country:US
Mailing Address - Phone:818-645-0831
Mailing Address - Fax:559-261-1543
Practice Address - Street 1:1457 W CHENNAULT AVE
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93711-0515
Practice Address - Country:US
Practice Address - Phone:818-645-0831
Practice Address - Fax:559-261-1543
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA32258225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist