Provider Demographics
NPI:1619429073
Name:DEL RIO, JOSE JR (ATC)
Entity Type:Individual
Prefix:
First Name:JOSE
Middle Name:
Last Name:DEL RIO
Suffix:JR
Gender:M
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 DUNECREST AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-3429
Mailing Address - Country:US
Mailing Address - Phone:562-215-2667
Mailing Address - Fax:
Practice Address - Street 1:10 HARRIS CT
Practice Address - Street 2:
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-5704
Practice Address - Country:US
Practice Address - Phone:562-215-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-01
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer