Individual
DR. KIMBERLY IACOBAZZI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
7812 EDINGER AVE STE 400, HUNTINGTON BEACH, CA 92647-3727
(714) 916-0641
Mailing address
508 LONGFELLOW AVE, GLEN ELLYN, IL 60137-4715
(630) 253-3085
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
293920
CA
2251P0200X
Pediatric Physical Therapist
Primary
P21655
NC
Other
Enumeration date
11/20/2017
Last updated
09/27/2024
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