Provider Demographics
NPI:1922175330
Name:GARCIA-CUESTA, CARLOS (MSPT, MTC, ATC)
Entity Type:Individual
Prefix:
First Name:CARLOS
Middle Name:
Last Name:GARCIA-CUESTA
Suffix:
Gender:M
Credentials:MSPT, MTC, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19242 LAUREN LN
Mailing Address - Street 2:
Mailing Address - City:SANTA CLARITA
Mailing Address - State:CA
Mailing Address - Zip Code:91350-1344
Mailing Address - Country:US
Mailing Address - Phone:703-300-3226
Mailing Address - Fax:
Practice Address - Street 1:2051 STATHAM BLVD
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-3901
Practice Address - Country:US
Practice Address - Phone:730-300-3226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-29
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2305203630225100000X
CA299351225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist