Provider Demographics
NPI:1932375011
Name:PATAJO, JEFFERY PAUL ARGONZA (PT)
Entity Type:Individual
Prefix:MR
First Name:JEFFERY PAUL
Middle Name:ARGONZA
Last Name:PATAJO
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1752 N LANDFAIR ST
Mailing Address - Street 2:
Mailing Address - City:ANAHEIM
Mailing Address - State:CA
Mailing Address - Zip Code:92806-1108
Mailing Address - Country:US
Mailing Address - Phone:714-272-8396
Mailing Address - Fax:
Practice Address - Street 1:3201 W COMMERCIAL BLVD
Practice Address - Street 2:STE 116
Practice Address - City:FT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33309-3440
Practice Address - Country:US
Practice Address - Phone:800-886-8108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPT.012113225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist