Provider Demographics
NPI:1972389492
Name:QUIGAO, BELARMINO TEGON JR (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:BELARMINO
Middle Name:TEGON
Last Name:QUIGAO
Suffix:JR
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1609 N NORMANDIE AVE APT 504
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90027-5193
Mailing Address - Country:US
Mailing Address - Phone:213-327-5023
Mailing Address - Fax:
Practice Address - Street 1:1313 W 8TH ST STE 100
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90017-4422
Practice Address - Country:US
Practice Address - Phone:213-401-1970
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-01
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA302654225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist