Provider Demographics
NPI: | 1053905349 |
---|---|
Name: | CRUZ, OSCAR (RESPIRATORY THERAPIS) |
Entity type: | Individual |
Prefix: | |
First Name: | OSCAR |
Middle Name: | |
Last Name: | CRUZ |
Suffix: | |
Gender: | M |
Credentials: | RESPIRATORY THERAPIS |
Other - Prefix: | |
Other - First Name: | |
Other - Middle Name: | |
Other - Last Name: | |
Other - Suffix: | |
Other - Last Name Type: | |
Other - Credentials: | |
Mailing Address - Street 1: | 7507 BLOOMINGTON AVE |
Mailing Address - Street 2: | |
Mailing Address - City: | BURBANK |
Mailing Address - State: | CA |
Mailing Address - Zip Code: | 91504-1002 |
Mailing Address - Country: | US |
Mailing Address - Phone: | 818-216-5039 |
Mailing Address - Fax: | |
Practice Address - Street 1: | 7507 BLOOMINGTON AVE |
Practice Address - Street 2: | |
Practice Address - City: | BURBANK |
Practice Address - State: | CA |
Practice Address - Zip Code: | 91504-1002 |
Practice Address - Country: | US |
Practice Address - Phone: | 818-216-5039 |
Practice Address - Fax: | |
Is Sole Proprietor?: | Yes |
Enumeration Date: | 2021-02-26 |
Last Update Date: | 2021-02-26 |
Deactivation Date: | |
Deactivation Code: | |
Reactivation Date: |
Provider Licenses
State | License ID | Taxonomies |
---|---|---|
CA | 27751 | 2278E0002X, 227800000X, 2278E1000X, 2278H0200X, 2278P4000X, 2278G1100X |
Provider Taxonomies
Primary? | Code | Type | Classification | Specialization | Group |
---|---|---|---|---|---|
Yes | 2278G1100X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | General Care | Group - Single Specialty |
No | 2278E0002X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Emergency Care | |
No | 227800000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | ||
No | 2278E1000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Educational | |
No | 2278H0200X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Home Health | Group - Single Specialty |
No | 2278P4000X | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Respiratory Therapist, Certified | Patient Transport |