Provider Demographics
NPI:1972834513
Name:PRESZLER, ERIC C (PT)
Entity Type:Individual
Prefix:
First Name:ERIC
Middle Name:C
Last Name:PRESZLER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:200 NEWPORT CENTER DR
Mailing Address - Street 2:#213
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660-7501
Mailing Address - Country:US
Mailing Address - Phone:949-644-1322
Mailing Address - Fax:949-644-0316
Practice Address - Street 1:5772 BOLSA AVE
Practice Address - Street 2:STE 101
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92649-1134
Practice Address - Country:US
Practice Address - Phone:714-897-3589
Practice Address - Fax:714-897-1316
Is Sole Proprietor?:No
Enumeration Date:2010-01-21
Last Update Date:2010-03-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAPT 36427225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACW509ZMedicare PIN