Provider Demographics
NPI:1760494843
Name:ABIERA, SALVADOR LOLARGA III (DPT, PT)
Entity Type:Individual
Prefix:DR
First Name:SALVADOR
Middle Name:LOLARGA
Last Name:ABIERA
Suffix:III
Gender:M
Credentials:DPT, PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:941 PERCHERON DR
Mailing Address - Street 2:
Mailing Address - City:WALNUT
Mailing Address - State:CA
Mailing Address - Zip Code:91789-0910
Mailing Address - Country:US
Mailing Address - Phone:626-536-0126
Mailing Address - Fax:909-598-8293
Practice Address - Street 1:941 PERCHERON DR
Practice Address - Street 2:
Practice Address - City:WALNUT
Practice Address - State:CA
Practice Address - Zip Code:91789-0910
Practice Address - Country:US
Practice Address - Phone:626-536-0126
Practice Address - Fax:909-598-8293
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2013-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT148282251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT148282OtherPHYSICAL THERAPY LICENSE
CAWPT14828AMedicare ID - Type UnspecifiedPHYSICAL THERAPIST