Provider Demographics
NPI:1457711194
Name:FRANCO, ERNEST (RPT)
Entity Type:Individual
Prefix:MR
First Name:ERNEST
Middle Name:
Last Name:FRANCO
Suffix:
Gender:M
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7142 GREEN GLEN CT
Mailing Address - Street 2:
Mailing Address - City:RANCHO CUCAMONGA
Mailing Address - State:CA
Mailing Address - Zip Code:91739-9636
Mailing Address - Country:US
Mailing Address - Phone:909-463-3714
Mailing Address - Fax:
Practice Address - Street 1:7142 GREEN GLEN CT
Practice Address - Street 2:
Practice Address - City:RANCHO CUCAMONGA
Practice Address - State:CA
Practice Address - Zip Code:91739-9636
Practice Address - Country:US
Practice Address - Phone:909-463-3714
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-23
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA29041225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1OtherPHYSICAL THERAPY PRACTICE