Provider Demographics
NPI:1134211782
Name:HAYASHIDA, MAURY H (DPT)
Entity type:Individual
Prefix:
First Name:MAURY
Middle Name:H
Last Name:HAYASHIDA
Suffix:
Gender:M
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:465 CARLO DR
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93117-1751
Mailing Address - Country:US
Mailing Address - Phone:805-683-2133
Mailing Address - Fax:
Practice Address - Street 1:7070 MARKET PLACE DR
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-5902
Practice Address - Country:US
Practice Address - Phone:805-685-1755
Practice Address - Fax:805-685-1715
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT247242251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAWPT24724AMedicare ID - Type Unspecified