Provider Demographics
NPI:1649708553
Name:ZARENO, DAVE ALZONO (DPT)
Entity type:Individual
Prefix:DR
First Name:DAVE
Middle Name:ALZONO
Last Name:ZARENO
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:PO BOX 101722
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91189-1772
Mailing Address - Country:US
Mailing Address - Phone:818-990-9930
Mailing Address - Fax:866-774-9459
Practice Address - Street 1:16550 VENTURA BLVD STE 120
Practice Address - Street 2:
Practice Address - City:ENCINO
Practice Address - State:CA
Practice Address - Zip Code:91436-2014
Practice Address - Country:US
Practice Address - Phone:818-990-9930
Practice Address - Fax:866-897-8508
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2017-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT292803225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist