Provider Demographics
NPI:1578700167
Name:PADAYHAG, JOEVIL UNGAB (PT)
Entity Type:Individual
Prefix:MR
First Name:JOEVIL
Middle Name:UNGAB
Last Name:PADAYHAG
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5610 WELLAND AVE
Mailing Address - Street 2:APT. 26-B
Mailing Address - City:TEMPLE CITY
Mailing Address - State:CA
Mailing Address - Zip Code:91780-2951
Mailing Address - Country:US
Mailing Address - Phone:626-203-9573
Mailing Address - Fax:626-446-4634
Practice Address - Street 1:5610 WELLAND AVE
Practice Address - Street 2:APT. 26-B
Practice Address - City:TEMPLE CITY
Practice Address - State:CA
Practice Address - Zip Code:91780-2951
Practice Address - Country:US
Practice Address - Phone:626-203-9573
Practice Address - Fax:626-446-4634
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA27620225100000X
283X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No283X00000XHospitalsRehabilitation Hospital