Provider Demographics
NPI:1740517242
Name:ORANGE COUNTY GERIATRIC PHYSICAL THERAPY
Entity type:Organization
Organization Name:ORANGE COUNTY GERIATRIC PHYSICAL THERAPY
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:IULIAN
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUGOJ
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:714-726-2804
Mailing Address - Street 1:1532 RAINBOW DR
Mailing Address - Street 2:
Mailing Address - City:SANTA ANA
Mailing Address - State:CA
Mailing Address - Zip Code:92705-3430
Mailing Address - Country:US
Mailing Address - Phone:714-368-0289
Mailing Address - Fax:714-368-0289
Practice Address - Street 1:1532 RAINBOW DR
Practice Address - Street 2:
Practice Address - City:SANTA ANA
Practice Address - State:CA
Practice Address - Zip Code:92705-3430
Practice Address - Country:US
Practice Address - Phone:714-368-0289
Practice Address - Fax:714-368-0289
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-05
Last Update Date:2009-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA28777261QP2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical Therapy