Provider Demographics
NPI:1861675977
Name:CATUDIO, NEIL SALVADOR DALA (PT)
Entity Type:Individual
Prefix:MR
First Name:NEIL SALVADOR
Middle Name:DALA
Last Name:CATUDIO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:247 E BOBIER DR
Mailing Address - Street 2:
Mailing Address - City:VISTA
Mailing Address - State:CA
Mailing Address - Zip Code:92084-3026
Mailing Address - Country:US
Mailing Address - Phone:760-945-3033
Mailing Address - Fax:
Practice Address - Street 1:247 E BOBIER DR
Practice Address - Street 2:
Practice Address - City:VISTA
Practice Address - State:CA
Practice Address - Zip Code:92084-3026
Practice Address - Country:US
Practice Address - Phone:760-945-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-11
Last Update Date:2020-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA414692251G0304X
IL0700160622251X0800X
2251G0304X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatricsGroup - Single Specialty
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedicGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1861675977Medicaid
CA1861675977Medicaid