Provider Demographics
NPI:1801210042
Name:TOSCANO, DOMINIC PETER (RPT)
Entity Type:Individual
Prefix:
First Name:DOMINIC
Middle Name:PETER
Last Name:TOSCANO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9338 TARRYTON AVE
Mailing Address - Street 2:
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90605-2543
Mailing Address - Country:US
Mailing Address - Phone:646-703-1906
Mailing Address - Fax:
Practice Address - Street 1:1801 S LA CIENEGA BLVD
Practice Address - Street 2:SUITE #203
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90035-4641
Practice Address - Country:US
Practice Address - Phone:310-287-3711
Practice Address - Fax:310-287-3717
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPT40687225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist