Provider Demographics
NPI:1689239139
Name:CABIGAS, LEO VIR YPARRAGUIRRE (PTA)
Entity Type:Individual
Prefix:
First Name:LEO VIR
Middle Name:YPARRAGUIRRE
Last Name:CABIGAS
Suffix:
Gender:M
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1053 EUCALYPTUS LN
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91103-3006
Mailing Address - Country:US
Mailing Address - Phone:626-710-2308
Mailing Address - Fax:
Practice Address - Street 1:915 CRENSHAW BLVD
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90019-1938
Practice Address - Country:US
Practice Address - Phone:323-937-5466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-05-09
Last Update Date:2019-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
11202225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant