Provider Demographics
NPI:1639109333
Name:SARIELDIN, MAGDY S (PHYSICAL THERAPIST)
Entity type:Individual
Prefix:
First Name:MAGDY
Middle Name:S
Last Name:SARIELDIN
Suffix:
Gender:M
Credentials:PHYSICAL THERAPIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24205 DELTA DR
Mailing Address - Street 2:
Mailing Address - City:DIAMOND BAR
Mailing Address - State:CA
Mailing Address - Zip Code:91765-4305
Mailing Address - Country:US
Mailing Address - Phone:909-599-0774
Mailing Address - Fax:909-599-8169
Practice Address - Street 1:1111 W COVINA BLVD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAN DIMAS
Practice Address - State:CA
Practice Address - Zip Code:91773-3205
Practice Address - Country:US
Practice Address - Phone:909-599-0774
Practice Address - Fax:909-599-8169
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA7811225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAPT7811Medicare ID - Type UnspecifiedPHYSICAL THERAPIST