Provider Demographics
NPI:1639596778
Name:CUASAY, CONRADO JR (PT)
Entity Type:Individual
Prefix:MR
First Name:CONRADO
Middle Name:
Last Name:CUASAY
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3760 CONVOY STREET
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-3744
Mailing Address - Country:US
Mailing Address - Phone:858-514-0375
Mailing Address - Fax:858-514-0383
Practice Address - Street 1:1088 LAGUNA DRIVE
Practice Address - Street 2:
Practice Address - City:CARLSBAD
Practice Address - State:CA
Practice Address - Zip Code:92008-1896
Practice Address - Country:US
Practice Address - Phone:760-720-3196
Practice Address - Fax:760-434-5967
Is Sole Proprietor?:No
Enumeration Date:2014-03-26
Last Update Date:2014-03-26
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA37371225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist