Provider Demographics
NPI:1821157249
Name:MAALIHAN, JOSE PANO JR (PT)
Entity Type:Individual
Prefix:MR
First Name:JOSE
Middle Name:PANO
Last Name:MAALIHAN
Suffix:JR
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:JOEY
Other - Middle Name:P
Other - Last Name:MAALIHAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:1200 EL CAMINO REAL
Mailing Address - Street 2:
Mailing Address - City:SOUTH SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94080-3208
Mailing Address - Country:US
Mailing Address - Phone:650-742-7289
Mailing Address - Fax:650-742-7295
Practice Address - Street 1:801 TRAEGER AVE
Practice Address - Street 2:
Practice Address - City:SAN BRUNO
Practice Address - State:CA
Practice Address - Zip Code:94066-3048
Practice Address - Country:US
Practice Address - Phone:650-742-7289
Practice Address - Fax:650-742-7295
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist