Provider Demographics
NPI:1952665077
Name:PASCO ,JR., ARMANDO LAQUI (PT)
Entity Type:Individual
Prefix:
First Name:ARMANDO
Middle Name:LAQUI
Last Name:PASCO ,JR.
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 1:27136 PASEO ESPADA STE B1103
Mailing Address - Street 2:
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-2737
Mailing Address - Country:US
Mailing Address - Phone:949-429-3220
Mailing Address - Fax:949-429-3885
Practice Address - Street 1:12832 GARDEN GROVE BLVD STE B
Practice Address - Street 2:
Practice Address - City:GARDEN GROVE
Practice Address - State:CA
Practice Address - Zip Code:92843-2014
Practice Address - Country:US
Practice Address - Phone:714-467-0293
Practice Address - Fax:714-467-0298
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-03
Last Update Date:2012-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17471225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist