Provider Demographics
NPI:1710311857
Name:DAI, DEXTER (DPT)
Entity Type:Individual
Prefix:
First Name:DEXTER
Middle Name:
Last Name:DAI
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 1:1500 S GLADYS AVE
Mailing Address - Street 2:
Mailing Address - City:SAN GABRIEL
Mailing Address - State:CA
Mailing Address - Zip Code:91776-3628
Mailing Address - Country:US
Mailing Address - Phone:626-200-5917
Mailing Address - Fax:
Practice Address - Street 1:640 S PLACENTIA AVE
Practice Address - Street 2:
Practice Address - City:PLACENTIA
Practice Address - State:CA
Practice Address - Zip Code:92870-6300
Practice Address - Country:US
Practice Address - Phone:714-579-7772
Practice Address - Fax:714-579-7781
Is Sole Proprietor?:No
Enumeration Date:2013-08-26
Last Update Date:2014-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA40489225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist