Provider Demographics
NPI:1619032331
Name:PATON, HAILEY JOY (MPT)
Entity Type:Individual
Prefix:
First Name:HAILEY
Middle Name:JOY
Last Name:PATON
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:4105 OCEAN VIEW BLVD
Mailing Address - Street 2:STE D
Mailing Address - City:MONTROSE
Mailing Address - State:CA
Mailing Address - Zip Code:91020-1576
Mailing Address - Country:US
Mailing Address - Phone:818-330-7335
Mailing Address - Fax:818-330-7336
Practice Address - Street 1:542 FOOTHILL BLVD
Practice Address - Street 2:
Practice Address - City:LA CANADA
Practice Address - State:CA
Practice Address - Zip Code:91011-3506
Practice Address - Country:US
Practice Address - Phone:818-952-3676
Practice Address - Fax:818-952-3677
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2017-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA25948225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW16071Medicare ID - Type Unspecified