Provider Demographics
NPI:1780758284
Name:MAGNUSSON, JAMES ARTHUR (PT)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:ARTHUR
Last Name:MAGNUSSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2381 MAGDA CIR
Mailing Address - Street 2:
Mailing Address - City:THOUSAND OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91360-1829
Mailing Address - Country:US
Mailing Address - Phone:805-494-4536
Mailing Address - Fax:
Practice Address - Street 1:1651 E. CHANNEL ISLAND BLVD SUITE 2
Practice Address - Street 2:
Practice Address - City:OXNARD
Practice Address - State:CA
Practice Address - Zip Code:93033-5617
Practice Address - Country:US
Practice Address - Phone:805-240-3373
Practice Address - Fax:805-240-3375
Is Sole Proprietor?:No
Enumeration Date:2006-11-17
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT15163225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT15163OtherPT LICENSE