Provider Demographics
NPI:1508504929
Name:MAGANA, FRANK BILLY III (PTA)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:BILLY
Last Name:MAGANA
Suffix:III
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5739 HERSHOLT AVE
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90712-2032
Mailing Address - Country:US
Mailing Address - Phone:469-386-5855
Mailing Address - Fax:
Practice Address - Street 1:5739 HERSHOLT AVE
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:CA
Practice Address - Zip Code:90712-2032
Practice Address - Country:US
Practice Address - Phone:469-386-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-25
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA51857225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant