Provider Demographics
NPI:1578021325
Name:DELGADO, CARLOS ARMANDO (PT, DPT)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:ARMANDO
Last Name:DELGADO
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 1:360 S EUCLID AVE UNIT 217
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-3165
Mailing Address - Country:US
Mailing Address - Phone:209-808-2267
Mailing Address - Fax:
Practice Address - Street 1:959 E WALNUT ST STE 240
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-5348
Practice Address - Country:US
Practice Address - Phone:626-795-2390
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA295757225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist