Provider Demographics
NPI:1518432855
Name:MACABUHAY, JOHN ALEXANDER SY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:JOHN ALEXANDER
Middle Name:SY
Last Name:MACABUHAY
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 N LAKE AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-5120
Mailing Address - Country:US
Mailing Address - Phone:909-389-8565
Mailing Address - Fax:
Practice Address - Street 1:301 N LAKE AVE STE 201
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-5120
Practice Address - Country:US
Practice Address - Phone:626-568-9115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-12
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295271225100000X
CAPT295271261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy