Provider Demographics
NPI:1700196078
Name:CAVA, DOMENICK (DPT)
Entity Type:Individual
Prefix:DR
First Name:DOMENICK
Middle Name:
Last Name:CAVA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 UPPER RAGSDALE DR
Mailing Address - Street 2:SUITE 180
Mailing Address - City:MONTEREY
Mailing Address - State:CA
Mailing Address - Zip Code:93940-7881
Mailing Address - Country:US
Mailing Address - Phone:831-643-1234
Mailing Address - Fax:831-643-1233
Practice Address - Street 1:19 UPPER RAGSDALE DR
Practice Address - Street 2:SUITE 180
Practice Address - City:MONTEREY
Practice Address - State:CA
Practice Address - Zip Code:93940-7881
Practice Address - Country:US
Practice Address - Phone:831-643-1234
Practice Address - Fax:831-643-1233
Is Sole Proprietor?:No
Enumeration Date:2010-10-20
Last Update Date:2014-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60192083225100000X
CA386862251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist