Provider Demographics
NPI:1396796371
Name:DO, KATRINA TRAM (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:TRAM
Last Name:DO
Suffix:
Gender:F
Credentials:PHYSICAL THERAPIST
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Mailing Address - Street 1:15321 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92647-2615
Mailing Address - Country:US
Mailing Address - Phone:714-898-0250
Mailing Address - Fax:
Practice Address - Street 1:15321 VICTORIA LN
Practice Address - Street 2:
Practice Address - City:HUNTINGTON BEACH
Practice Address - State:CA
Practice Address - Zip Code:92647-2615
Practice Address - Country:US
Practice Address - Phone:714-898-0250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-13
Last Update Date:2015-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT28524225100000X, 2251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist