Individual
RUSALY MOHAMMAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
4510 E PACIFIC COAST HIGHWAY, #305, LONG BEACH, CA 90804
(562) 494-8094
(562) 494-8057
Mailing address
14911 YUCCA AVE, IRVINE, CA 92606
(949) 653-6426
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
AT8258
CA
Other
Enumeration date
09/20/2006
Last updated
07/08/2007
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