Provider Demographics
NPI:1710700380
Name:ALQUISIRA, ARTURO ALBERTO
Entity type:Individual
Prefix:
First Name:ARTURO
Middle Name:ALBERTO
Last Name:ALQUISIRA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3340 1/2 ANDRITA ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90065-2906
Mailing Address - Country:US
Mailing Address - Phone:323-360-2412
Mailing Address - Fax:
Practice Address - Street 1:5806 PACIFIC BLVD
Practice Address - Street 2:
Practice Address - City:HUNTINGTON PARK
Practice Address - State:CA
Practice Address - Zip Code:90255-2618
Practice Address - Country:US
Practice Address - Phone:818-894-2273
Practice Address - Fax:818-357-2505
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA52829225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant