Provider Demographics
NPI:1629182514
Name:MACDONALD, ROBERT JAMES II (DR PHYSICAL THERAPY)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:JAMES
Last Name:MACDONALD
Suffix:II
Gender:M
Credentials:DR PHYSICAL THERAPY
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Other - First Name:
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Mailing Address - Street 1:6301 FARINELLA DR
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-4221
Mailing Address - Country:US
Mailing Address - Phone:714-840-5671
Mailing Address - Fax:562-799-8832
Practice Address - Street 1:18800 MAIN ST
Practice Address - Street 2:SUITE 104
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92648-1707
Practice Address - Country:US
Practice Address - Phone:714-843-9077
Practice Address - Fax:562-799-8832
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT24666174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist