Provider Demographics
NPI:1568619534
Name:PABUAYA, CHONA (PT)
Entity Type:Individual
Prefix:
First Name:CHONA
Middle Name:
Last Name:PABUAYA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1154 N DRESDEN ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92801-1971
Mailing Address - Country:US
Mailing Address - Phone:714-414-2517
Mailing Address - Fax:
Practice Address - Street 1:1154 N DRESDEN ST
Practice Address - Street 2:
Practice Address - City:ANAHEIM
Practice Address - State:CA
Practice Address - Zip Code:92801-1971
Practice Address - Country:US
Practice Address - Phone:714-414-2517
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-08-21
Last Update Date:2008-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT 32294225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist