Individual
BECKETT CHARLES GANDOLFI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
15 CORPORATE PLAZA DR, NEWPORT BEACH, CA 92660-7918
(949) 759-1840
Mailing address
363 NEWPORT AVE UNIT 303, LONG BEACH, CA 90814-8103
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
Other
Enumeration date
09/10/2021
Last updated
09/10/2021
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