Provider Demographics
NPI:1952478240
Name:LONA, JOSE RAUL (DPT)
Entity Type:Individual
Prefix:DR
First Name:JOSE
Middle Name:RAUL
Last Name:LONA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:DR
Other - First Name:J
Other - Middle Name:RAUL
Other - Last Name:LONA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:10474 SANTA MONICA BLVD
Mailing Address - Street 2:SUITE 435
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90025-6929
Mailing Address - Country:US
Mailing Address - Phone:310-275-4137
Mailing Address - Fax:310-274-1815
Practice Address - Street 1:10474 SANTA MONICA BLVD
Practice Address - Street 2:SUITE 435
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90025-6929
Practice Address - Country:US
Practice Address - Phone:310-275-4137
Practice Address - Fax:310-274-1815
Is Sole Proprietor?:No
Enumeration Date:2006-11-29
Last Update Date:2012-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA264062251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT26406AMedicare UPIN