Provider Demographics
NPI:1740745710
Name:CENIDOZA, DENVER ARANDA (PHYSICAL THERAPIST)
Entity Type:Individual
Prefix:
First Name:DENVER
Middle Name:ARANDA
Last Name:CENIDOZA
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 LA MIRADA BLVD
Mailing Address - Street 2:
Mailing Address - City:LA MIRADA
Mailing Address - State:CA
Mailing Address - Zip Code:90638-1306
Mailing Address - Country:US
Mailing Address - Phone:562-947-8691
Mailing Address - Fax:
Practice Address - Street 1:12200 LA MIRADA BLVD
Practice Address - Street 2:
Practice Address - City:LA MIRADA
Practice Address - State:CA
Practice Address - Zip Code:90638-1306
Practice Address - Country:US
Practice Address - Phone:562-947-8691
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-02-04
Last Update Date:2019-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA370822251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics