Basic Information
| Provider Information | |||||||||
| NPI: | 1104838929 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | MUYCO | ||||||||
| FirstName: | EMERSON | ||||||||
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| NamePrefix: | MR. | ||||||||
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| Credential: | M.P.T | ||||||||
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| Mailing Information | |||||||||
| Address1: | 726 SANTA PAULA AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940853418 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087184323 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 1195 E ARQUES AVE | ||||||||
| Address2: | |||||||||
| City: | SUNNYVALE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 940853904 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4087739000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/12/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 225100000X | 24901 | CA | Y | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | Physical Therapist |
No ID Information.