Individual
ROMMEL BANTOG DIJON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
23232 PERALTA DR, 113, LAGUNA HILLS, CA 92653-1443
(949) 922-2776
Mailing address
17401 LA BONITA WAY, CERRITOS, CA 90703-9037
(562) 484-4329
Taxonomy
Speciality
Code
Description
License number
State
2251G0304X
Geriatric Physical Therapist
Primary
PT23752
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
W18659
MEDICARE GROUP PTAN
CA
Enumeration date
01/11/2008
Last updated
04/03/2009
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