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Organization
POMONA VALLEY ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, INC
Active
Organization
POMONA VALLEY ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, INC
Active
Other names
Gary M. Souza, PT & Associates
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GARY SOUZA DPT, OCS (OWNER,PRESIDENT)
(909) 861-3511
Entity
Organization
Contact information
Practice address
21015 PATHFINDER RD, SUITE 100, DIAMOND BAR, CA 91765-4018
(909) 861-3511
(909) 860-7900
Mailing address
21015 PATHFINDER RD, SUITE 100, DIAMOND BAR, CA 91765-4018
(909) 861-3511
(909) 860-7900
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT10462
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DC9491
RAILROAD MEDICARE GROUP #
CA
Enumeration date
01/23/2006
Last updated
08/07/2020
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