Individual
JOSHUA KYLE TINDAAN BANIWAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1440 S EUCLID ST, ANAHEIM, CA 92802-2156
(714) 535-7264
Mailing address
3832 PERIDOT CT, PERRIS, CA 92570-7287
(180) 527-6806
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
51374
CA
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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