Provider Demographics
NPI:1497426852
Name:TOUYA, CORENTIN
Entity Type:Individual
Prefix:
First Name:CORENTIN
Middle Name:
Last Name:TOUYA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26951 LA ALAMEDA APT 1310
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-7383
Mailing Address - Country:US
Mailing Address - Phone:323-608-2948
Mailing Address - Fax:
Practice Address - Street 1:26951 LA ALAMEDA APT 1310
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-7383
Practice Address - Country:US
Practice Address - Phone:323-608-2948
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA2255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer