Provider Demographics
NPI:1740428382
Name:MAGLUYAN, MYRA ANN (OTR/L)
Entity Type:Individual
Prefix:MISS
First Name:MYRA
Middle Name:ANN
Last Name:MAGLUYAN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 ROOSEVELT
Mailing Address - Street 2:SUITE 100
Mailing Address - City:IRVINE
Mailing Address - State:CA
Mailing Address - Zip Code:92620-3670
Mailing Address - Country:US
Mailing Address - Phone:949-333-6400
Mailing Address - Fax:949-333-6441
Practice Address - Street 1:980 ROOSEVELT
Practice Address - Street 2:SUITE 100
Practice Address - City:IRVINE
Practice Address - State:CA
Practice Address - Zip Code:92620-3670
Practice Address - Country:US
Practice Address - Phone:949-333-6400
Practice Address - Fax:949-333-6441
Is Sole Proprietor?:No
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA9107225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics